Qualidade da dieta e estado nutricional de pessoas vivendo com HIV em terapia com dolutegravir atendidas em um serviço de referência em Belo Horizonte/MG.

Abstract

The introduction of antiretroviral therapy (ART) resulted in an increase in life expectancy and brought significant improvements to the health conditions of people living with HIV (PLWHIV). On the other hand, there was an increase in obesity, diabetes, hypertension and cardiovascular diseases, resulting in greater mortality risks in this population. In Brazil, as of 2017, the first-line ART established for adults is the combination of tenofovir with lamivudine, both nucleoside analogue reverse transcriptase inhibitors, associated with dolutegravir (DTG), an integrase inhibitor. It has been demonstrated that individuals using DTG have a significant increase in body weight when compared to those using other antiretroviral regimens. The mechanisms that promote this weight gain are still unclear in the literature. Considering the multifactorial nature of weight gain, it is essential to evaluate the dietary pattern in this context. The general objective was to evaluate the diet quality and the nutritional status of PLWHIV using DTG, treated at a reference service in Belo Horizonte. This is a cross-sectional study, with individuals living with HIV, ≥ 18 years old who started DTG therapy, between February 2017 and March 2020. As a response variable, nutritional status was measured according to body mass index (BMI) and waist circumference (AC). The ma0in explanatory variable was diet quality, analysed using the Diet Quality Index instrument associated with the Digital Food Guide (DQI-DFG). The other explanatory variables were sociodemographic (gender, age, skin, colour, education, marital status, income), clinical (LTCD4+ lymphocytes and viral load), and that related to treatment (time of use of DTG). Among the 148 participants, 92.6% were men, with a mean age of 39.2 years (SD=11.1). The average time on ART was 54.9 months (SD=7.7). There was a 14.9% increase in the prevalence of excess weight among individuals, as well as a significant increase (1.73 (SD=2.2; p<0.001)) in BMI in relation to the beginning of treatment. At the time of the interview, 48% of individuals were overweighted and 24.3% were abdominally obese. The average IQD-GAD score was 45.17 (SD=11.16), in which 31.8% had a low-quality diet and 67. 4%, intermediate quality. Diet quality was predominantly intermediate to low, with a high prevalence of overweight and abdominal obesity. The consumption of whole grains, tubers and roots, fruits, vegetables, legumes and oilseeds and milk and dairy products was low, while the consumption of sugars and sweets, beef, pork and processed meat and refined cereals was high. No correlation was found between the time on ART and BMI, WC, energy intake and IQD-GAD, however, a trend is observed, considering that as the time on ART increases, there is a reduction in BMI, WC and energy intake, as well as an increase in diet quality. No correlation was found between diet quality and BMI and WC.