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HIV Med. 2018 Feb;19(2):123-131. doi: 10.1111/hiv.12561. Epub 2017 Nov 2.

Food insecurity may lead to incomplete HIV viral suppression and less immune reconstitution among HIV/hepatitis C virus-coinfected people.

Author information

1
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
2
Department of Medicine, McGill University, Montreal, QC, Canada.
3
Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.
4
Center for Clinical Epidemiology, Jewish General Hospital, Montreal, QC, Canada.

Abstract

OBJECTIVES:

The aim of this study was to determine the impact of food insecurity (FI) on HIV viral load and CD4 count among people coinfected with HIV and hepatitis C virus (HCV).

METHODS:

This study was conducted using data from the Food Security & HIV-HCV Sub-Study of the Canadian Co-Infection Cohort study. FI was measured using the adult scale of Health Canada's Household Food Security Survey Module and was classified into three categories: food security, moderate food insecurity and severe food insecurity. The association between FI, HIV viral load, and CD4 count was assessed using a stabilized inverse probability weighted marginal structural model.

RESULTS:

A total of 725 HIV/HCV-coinfected people with 1973 person-visits over 3 years of follow-up contributed to this study. At baseline, 23% of participants experienced moderate food insecurity and 34% experienced severe food insecurity. The proportion of people with undetectable HIV viral load was 75% and the median CD4 count was 460 [interquartile range (IQR): 300-665] cells/μL. People experiencing severe food insecurity had 1.47 times [95% confidence interval (CI): 1.14, 1.88] the risk of having detectable HIV viral load and a 0.91-fold (95% CI: 0.84, 0.98) increase in CD4 count compared with people who were food secure.

CONCLUSIONS:

These findings provide evidence of the negative impact of food insecurity on HIV viral load and CD4 count among HIV/HCV-coinfected people.

KEYWORDS:

CD4 count; HIV viral load; HIV/HCV coinfection; food insecurity; marginal structural model

PMID:
29094807
DOI:
10.1111/hiv.12561
[Indexed for MEDLINE]

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