Nourish : The role of nutrition as a determinant of immune function in patients with HIV infection receiving antiretroviral therapy in Uganda

Grijpink, L.C.M. (2017) Nourish : The role of nutrition as a determinant of immune function in patients with HIV infection receiving antiretroviral therapy in Uganda. thesis, Medicine.

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Abstract

HIV and malnutrition are intricately linked. In 2015, 36.7 million people worldwide were infected with HIV, with the majority of patients living in sub-Saharan Africa. 20–25% of patients receiving antiretroviral therapy (ART) also suffer from malnutrition. Both HIV and malnutrition are known to impair the immune system in different ways. This study investigated the influence of nutritional status and nutritional supplementation on circulating lymphocyte phenotypes and functions of adults with HIV infection in Uganda. 80 patients with HIV were subjected to a nutritional assessment. The frequencies and absolute numbers of circulating immune cell subsets were determined using flow cytometry. The ability of CD4+ and CD8+ T cells, natural killer (NK) cells and Vδ1 T cells to degranulate and produce interferon-γ, interleukin-4 (IL-4) and IL-17 was also investigated. CD4+ T cells were found to be expanded and Vδ1 T cells were depleted in patients who had received ART compared to ART-naïve patients. Additionally, CD4+ T cells, CD4+CD8+ double positive T cells and Vδ2 cells were depleted in severely malnourished ART-naïve patients compared to well-nourished ART-naïve patients. ART had a greater effect on lymphocyte phenotypes than nutritional status. Nutritional status did not significantly affect the ability of CD4+ or CD8+ T cells, NK cells or Vδ1 T cells to undergo cytolytic degranulation or cytokine production. Moderately malnourished patients were randomised into a group that were given 12 weeks of nutritional supplementation with Plumpy’Nut® and a group that received nutritional counselling only. ART combined with Plumpy’Nut® for 3 months did not significantly affect lymphocyte subset numbers or functions in comparison to ART alone. These data suggest that both ART and nutritional status can affect immune cell phenotypes but not their ability to mediate antiviral responses.

Item Type:	Thesis (Thesis)
Supervisor name:	Stienstra, Prof. dr Y.
Supervisor name:	Doherty, Dr. D. and Trinity College Dublin: Immunology
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:48
Last Modified:	25 Jun 2020 10:48
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/944

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