Hypophosphatemia in refeeding syndrome as a cause of early mortality in patients initiating antriretroviral therapy in Zambia
type: CreativeWork
description: Despite the numerous benefits seen with the introduction of antiretroviral therapy among people living with HIV/AIDS in low-income countries, there has been a surprisingly high mortality rate, especially in the first 90days of therapy. Causes of this early ART mortality are not well known in Zambia. It is probable that the high prevalence of malnutrition in sub-Saharan Africa, exacerbated in persons with HIV disease, is a major factor in early ART mortality.Refeeding syndrome in particular may be responsible for a portion of the early deaths. This syndrome occurs in persons with severe cachexia from any cause who experience sudden increases in food intake and nutrient absorption that exceeds the body's ability to meet the high phosphorous demands for metabolism of carbohydrate. The resulting hypophosphatemia could lead to adverse outcomes including cardiopulmonary failure and death.This study looked at a group of Zambians, who were HIV positive and just about to initiate antiretroviral therapy (ART) and the expected mortality in this group would be high. The aims of the study were:1.To determine whether refeeding syndrome occurs, and estimate its incidence.2.To determine whether persons who develop refeeding syndrome are at higher risk of early ART mortality or near mortality than persons who do not develop refeeding syndrome.Study participants were recruited from Chawama Clinic in Lusaka, Zambia and included 148 ART naive adult men and women initiating treatment and at high risk for early mortality.After obtaining consent, participants were scheduled for routine initiation of ART with usual 2-, 4-, 8-, and 12-week follow up visits after initiation of therapy. Because initial immunologic and clinical responses, intestinal changes, and refeeding syndrome could all occur in the first 1-2 weeks after ART begins, a 1 week post-ART visit was added for the puipose of this study. If eligible, in addition to routine procedures, including obtaining demographic and socioecono…
abstract: Despite the numerous benefits seen with the introduction of antiretroviral therapy among people living with HIV/AIDS in low-income countries, there has been a surprisingly high mortality rate, especially in the first 90days of therapy. Causes of this early ART mortality are not well known in Zambia. It is probable that the high prevalence of malnutrition in sub-Saharan Africa, exacerbated in persons with HIV disease, is a major factor in early ART mortality.Refeeding syndrome in particular may be responsible for a portion of the early deaths. This syndrome occurs in persons with severe cachexia from any cause who experience sudden increases in food intake and nutrient absorption that exceeds the body's ability to meet the high phosphorous demands for metabolism of carbohydrate. The resulting hypophosphatemia could lead to adverse outcomes including cardiopulmonary failure and death.This study looked at a group of Zambians, who were HIV positive and just about to initiate antiretroviral therapy (ART) and the expected mortality in this group would be high. The aims of the study were:1.To determine whether refeeding syndrome occurs, and estimate its incidence.2.To determine whether persons who develop refeeding syndrome are at higher risk of early ART mortality or near mortality than persons who do not develop refeeding syndrome.Study participants were recruited from Chawama Clinic in Lusaka, Zambia and included 148 ART naive adult men and women initiating treatment and at high risk for early mortality.After obtaining consent, participants were scheduled for routine initiation of ART with usual 2-, 4-, 8-, and 12-week follow up visits after initiation of therapy. Because initial immunologic and clinical responses, intestinal changes, and refeeding syndrome could all occur in the first 1-2 weeks after ART begins, a 1 week post-ART visit was added for the puipose of this study. If eligible, in addition to routine procedures, including obtaining demographic and socioecono…
author: Nyirenda, Christopher
language: en
keywords: Internal medicine, Antiretroviral therapy
date published: 2012-07-18
date modified: 2026-07-27T22:05:56Z
provider: University of Zambia
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: University of Zambia