The Nutritional Status of HIV-Infected US Adults

Background: Nutrition is critical to HIV mortality and morbidity. Improved treatment modalities have increased life expectancy of HIV-infected individuals. More than 1 million US adults are living with HIV, but little is known about their nutritional status. Objective: We aimed to characterize the nutritional status of those living with HIV with the use of the NHANES 2003–2014. Methods: The NHANES is a nationally representative, cross-sectional survey of the US population and includes a household interview, medical examination, and two 24-h dietary recalls; survey weights are applied to make the data nationally representative. HIV antibodies were ascertained initially by immunoassay and confirmed with Western blot. NHANES 2003–2014 data were analyzed for HIV-positive (n = 87) and HIV-negative (n = 15,868) US adults (aged 19–49 y). Body mass index (BMI), waist circumference, dietary intakes, and nutritional biomarkers were estimated and compared by HIV status, stratified by sex. Results: HIV-infected men and women had higher serum protein, lower serum albumin, and lower serum folate than did non–HIV-infected adults. HIV-positive women had significantly higher BMI, prevalence of overweight or obesity, and waist circumference risk and substantially lower serum 25-hydroxyvitamin D concentrations (44 compared with 65 nmol/L) than did HIV-negative women. When compared with HIV-negative women, HIV-positive women had lower intakes of some key nutrients such as fiber, vitamin E, vitamin K, magnesium, and potassium but had higher intakes of protein and niacin. Conclusions: The NHANES data suggest that HIV infection is associated with poorer markers of some nutritional status indicators; however, the US population prevalence of HIV is