Food insecurity and low CD4 count among HIV-infected people: a systematic review and meta-analysis
Food insecurity and low CD4 count among HIV-infected people: a systematic review and meta-analysis
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DOI：
10.1080/09540121.2016.1191613
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发表时间：
2016-01-01
影响因子：
1.7
通讯作者：
Brassard, Paul
中科院分区：
文献类型：
--
作者：
Aibibula, Wusiman;Cox, Joseph;Brassard, Paul
粮食不安全的定义是以社会可接受的方式获得可接受的食物的能力有限或不确定，或营养充足和安全的食物有限或不确定。虽然有效的抗逆转录病毒治疗可以显著增加大多数患者的CD 4计数，但仍有某些人群的CD 4计数水平相对较低。可能与CD 4恢复不良相关的因素已被广泛研究，但粮食不安全和低CD 4计数之间的关联在文献中并不一致。目的是系统地审查已发表的文献，以确定艾滋病毒感染者的粮食不安全和CD 4计数之间的关联。对PubMed、Web of Science、ProQuest ABI/INFORM Complete、奥维德Medline和EMBASE Classic以及相关研究的参考文献进行了系统性检索，检索截止日期为2015年5月，其中最早的数据库覆盖范围从1900年开始。定量评估粮食不安全与艾滋病毒感染者CD 4计数之间关系的研究符合纳入条件。研究结果采用随机效应模型进行总结。通过电子数据库检索和手工文献检索共检索到2093篇文献，其中8篇纳入本荟萃分析。粮食不安全人群的CD 4计数较低的几率是粮食安全人群的1.32倍（OR=1.32，95% CI：1.15-1.53），粮食不安全人群的CD 4细胞/μ l平均比粮食安全人群低91（平均差异=-91.09，95% CI：-156.16，-26.02）。根据艾滋病毒感染者的CD 4计数，粮食不安全可能是免疫恢复的一个潜在障碍。
Food insecurity is defined as a limited or uncertain ability to acquire acceptable foods in socially acceptable ways, or limited or uncertain availability of nutritionally adequate and safe foods. While effective antiretroviral treatment can significantly increase CD4 counts in the majority of patients, there are certain populations who remain at relatively low CD4 count levels. Factors possibly associated with poor CD4 recovery have been extensively studied, but the association between food insecurity and low CD4 count is inconsistent in the literature. The objective is to systematically review published literature to determine the association between food insecurity and CD4 count among HIV-infected people. PubMed, Web of Science, ProQuest ABI/INFORM Complete, Ovid Medline and EMBASE Classic, plus bibliographies of relevant studies were systematically searched up to May 2015, where the earliest database coverage started from 1900. Studies that quantitatively assessed the association between food insecurity and CD4 count among HIV-infected people were eligible for inclusion. Study results were summarized using random effects model. A total of 2093 articles were identified through electronic database search and manual bibliographic search, of which 8 studies included in this meta-analysis. Food insecure people had 1.32 times greater odds of having lower CD4 counts compared to food secure people (OR=1.32, 95% CI: 1.15-1.53) and food insecure people had on average 91 fewer CD4 cells/mu l compared to their food secure counterparts (mean difference=-91.09, 95% CI: -156.16, -26.02). Food insecurity could be a potential barrier to immune recovery as measured by CD4 counts among HIV-infected people.