Evaluation of the addition of moringa oleifera as a nutritional supplement on the anthropometric, viral load, and cd4 counts of adult hiv patients on antiretroviral therapy.

Abstract

Background: This thesis reports on studies conducted at the S. S Wali virology centre, Aminu Kano Teaching Hospital (AKTH), Kano State, Nigeria. The studies aimed to evaluate the addition of Moringa oleifera Lam. leaves powder as a nutritional supplement on the anthropometric and immune status of adult HIV patients on antiretroviral therapy (ART). The studies further assessed the quality of life (QoL) and dietary diversity of PLHIV. Method: The study was a six months double-blind randomized controlled trial conducted from December 2017 to November 2018. Two hundred consented patients on ART were randomly allocated to either Moringa oleifera Lam. group (MOG) or the control group (COG). The participants were followed for six months. The outcomes assessed were changes in anthropometric parameters (weight, body mass index [BMI], and mid-upper-arm circumference [MUAC], changes in immune status (CD4 cell count and viral load), and the impact of the intervention on quality of life (QoL) using the WHOQOLHIV-Bref questionnaire. Additionally, the dietary diversity of the patients was assessed using the FAO 24-hour dietary recall questionnaire. Results: One hundred and seventy-seven patients completed the six-month follow-up (89 MOG versus 88 COG). At study inception, both groups had similar socio-demographic, socioeconomic, nutritional status, and immunological characteristics. At both baseline and sixth month, a poor dietary diversity pattern was observed. The food groups most commonly consumed in both MOG and COG were cereals, spices and condiments, oils, fats and palm oil, and dark green vegetables. In both groups, participants were in the medium or low dietary diversity tercile. Over the study period, Moringa oleifera Lam. leaf supplementation did not have an impact on any of the anthropometric parameters measured. However, Moringa oleifera Lam. leaf supplementation intervention and ART were effective in improving the CD4 cell counts of the study participants. No effect was observed in the viral loads in both study groups. Supplementation with Moringa oleifera Lam. leaf for PLHIV that are on ART improves the quality of life (QoL) domains of physical, psychological, level of independence, and social relationships. Conclusion: The study suggests that nutritional supplementation with Moringa oleifera Lam. leaf has a beneficial effect among adult HIV patients on ART in a limited resource setting. In low-income settings like Nigeria, programs should consider nutritional supplementation as part of a comprehensive approach to ensure optimal treatment outcomes in people living with HIV and AIDS.