Editorial: Study confirms the merits of nutrition
Published in The Hindu on August 14, 2008
A large-scale study, involving more than 10, 500 people, undertaken by the Tamil Nadu State AIDS Control Society has conclusively demonstrated that providing micro and macro nutritional supplements to people with HIV/AIDS improves their health, and greatly delays the progression of the disease. The study included both HIV-infected individuals who did not require antiretroviral therapy and those on ART. The most important outcome has been an increase in the CD4 count. Although the increase has been remarkable — 113 at the start of the study to 402 at the end of the 18-month study period — in those on ART, the marginal increase seen in HIV-positive people who do not require drugs should not be overlooked. Since CD4 counts indicate how strong the immune system is, a higher count would mean it would take a longer time before therapy becomes necessary. For those already on ART, an increase in CD4 translates to preventing AIDS-related illnesses. A marked reduction in the tuberculosis co-infection rate and other opportunistic infections for those on ART best illustrates this. Though the advantages of a healthy lifestyle in delaying the progression of the disease are well known, the results of the Tamil Nadu study are powerful confirmation of this knowledge.
There are economic benefits as well, as the percentage of individuals on drugs who became employed nearly doubled within six months. Taken together, the twin benefits could change the entire dynamics of caring for those with HIV/AIDS. It is commendable that the State government decided in March-April 2008, on the basis of six-month data, to incorporate in its HIV/AIDS strategy nutritional supplementation for those on therapy. The final results have proved that the benefits are substantial, thus making a strong case for continuing the programme. There are about 25,000 people on ART in Tamil Nadu, and this number increases by about 1,000 every month. But with the current programme restricted to those on medicines, the only way to ensure that the infected people take a longer time before requiring therapy is by creating more awareness. The role of counsellors in educating infected people on the importance of nutrition cannot be overemphasised. The findings of the study also make a strong case for the National AIDS Control Organisation to include nutritional supplementation as part of its all-India programme. The additional cost of supplementation, which works out to Rs.900 per person annually, is eminently justifiable considering that the government may not be required to spend money on treating thousands of people who would otherwise become co-infected with TB or get afflicted with opportunistic infections.
