Editorial: A significant pilot study
Published in The Hindu on March 21, 2007
Tamil Nadu has been in the forefront in implementing HIV/AIDS prevention and control measures since the early 1990s and the latest initiative to be undertaken by the Tamil Nadu State AIDS Control Society (TANSACS) along with the World Food Programme reaffirms the State’s commitment in tackling the disease. A pilot programme for supplying free nutritional supplement to more than 13,000 persons with HIV/AIDS and who have registered for free antiretroviral therapy (ART) in the 15 centres across the State is slated to begin next month. The programme is the first of its kind in India. There exists a large body of evidence to suggest that those with HIV/AIDS suffered from energy deficiency, particularly micronutrient deficiency, because of reduced dietary intake, increased energy expenditure, and malabsorption of nutrients by the body. It is well known that early detection and treatment, combined with a regime of balanced diet and regular physical exercise, delays the progression of HIV infection. Less clearly understood is the role of macro- and micronutrient supplements, such as vitamins, iron, magnesium, and zinc in realising that objective. Studies have been carried out in several countries, particularly in Africa, to assess the importance of these supplements in meeting the nutrient requirements of those with HIV/AIDS. However, the larger question of such supplementation’s role in delaying the progression of HIV infection remains largely inconclusive.
Against this backdrop, the proposed pilot study by TANSACS may help in providing some valuable information, in assessing the role of micronutritional supplementation in maintaining the proper immunological function among the affected. Small-scale studies have shown that CD4 counts remained largely unchanged in those with HIV/AIDS receiving nutritional supplements compared with the control group, and there was better adherence to medication as well. While the positive results from the two small-scale studies of shorter duration have prompted TANSACS to undertake the pilot study, it will be prudent not to expect similar results from a large-scale study involving more people and spanning a longer duration. However, any positive result from the pilot study will help India as well as other developing countries in evolving strategies to correct micronutrient deficiencies in those receiving antiretroviral therapy. It is for this reason that the programme of TANSACS and the WFP will be watched closely by the HIV/AIDS community across the world. It is therefore imperative that any results, even if they turn out to be negative, are made public for the greater benefit of the society.
