ArticlePloS one2022
Effects of undernutrition on opportunistic infections among adults living with HIV on ART in Northwest Ethiopia: Using inverse-probability weighting.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 4 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 4 syntheses or guidelines pooled it, 21 citations in OpenAlex.
- Prevalence and associated factors of undernutrition among adults living with HIV in ethiopia: a systematic review and meta-analysis.Journal of health, population, and nutrition · 2025Pooled it
- Incidence rate of mortality and its predictors among tuberculosis and human immunodeficiency virus coinfected patients on antiretroviral therapy in Ethiopia: systematic review and meta-analysis.Frontiers in medicine · 2024Pooled it
- Prevalence and risk factors of malnutrition in patients with pulmonary tuberculosis: a systematic review and meta-analysis.Frontiers in medicine · 2023Pooled it
- Pooled it
- Predictors of nutritional recovery among undernourished adults on antiretroviral therapy treated with ready-to-use therapeutic food at public health facilities in Southeast Ethiopia: a retrospective cohort study.BMC infectious diseases · 2025Article
- A competing risk analysis of predictors of time to lost to follow-up among adults with TB/HIV coinfection in Bahir Dar.Scientific reports · 2025Article
- Under-nutrition and its associated factors among adult second-line antiretroviral treatment users in Northern Ethiopia.BMC public health · 2025Article
- Dietary diversity and opportunistic infections among adults living with human immunodeficiency virus on antiretroviral therapy in Kumasi metropolis; a facility-based cross-sectional study.BMC infectious diseases · 2025Article
- Time-dependent predictors of loss to follow-up in HIV care in low-resource settings: A competing risks approach.PloS one · 2025Article
- Trends of Body Mass Index changes among adults on antiretroviral therapy in Northwest Ethiopia: a longitudinal data analysis.Scientific reports · 2024Article
- Investigating the follow-up discontinuation among people living with HIV in North Shoa Zone, Oromia, Ethiopia.Frontiers in public health · 2024Article
- Prevalence of Micronutrient Deficiency among People Living with HIV in Selected Rural Districts of the Eastern Cape Province of South Africa.Nutrients · 2023Article
- Association Between Body Mass Index Variation and Early Mortality Among 834 Ethiopian Adults Living with HIV on ART: A Joint Modelling Approach.Infectious diseases and therapy · 2023Article
- Predictors of a high incidence of opportunistic infections among HIV-infected children receiving antiretroviral therapy at Amhara regional state comprehensive specialized hospitals, Ethiopia: A multicenter institution-based retrospective follow-up study.Frontiers in pediatrics · 2023Article
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4 authors at 2 institutions in 4 countries.
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Abstract
backgroundOpportunistic infections (OIs) are the leading causes of hospitalization, morbidity, and mortality (accounting for 94.1% of all deaths) in people living with human immunodeficiency virus (PLHIV). Despite evidence suggested that undernutrition significantly increases the risk of OIs in PLHIV, to our knowledge, no study has examined the actual effects of undernutrition on OIs in this population, particularly in low-income countries. Thus, this study examined the effects of undernutrition on OIs in adults living with HIV receiving antiretroviral therapy (ART).
methodsWe conducted a retrospective cohort study among 841adults living with HIV receiving ART between June 2014 and June 2020 at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia. Study participants were selected using a simple random sampling technique. Data from participants' medical records were extracted using a project-specific data extraction checklist. The Kaplan Meier survival curve estimated the OIs free survival time. The effects of undernutrition on time to develop OIs was estimated using inverse-probability weighting. Finally, regression coefficients with 95% confidence intervals (95% CIs) were reported, with a statistical significance of p < 0.05.
resultsOf 841 study participants, 262 (31.2%) developed OIs, and the overall incidence rate was 16.7 (95% CI: 14.8, 18.8) per 100 person-years. The incWidence of OIs in undernourished participants (21/100 person-years, 95% CI: 17.8, 27.4) was higher than well-nourished participants (15.0/100 person-years, 95% CI: 12.9, 17.4). When everyone in the population of interest is well-nourished, average time to develop OIs is estimated as 26.5 (coefficient: 26.5, 95% CI: 20.6, 32.4, p < 0.001) months. When everyone in the population of interest is undernourished, average time to develop OIs is estimated as 17.7 (95% CI: 12.8, 22.6) months. However, when everyone is undernourished, average time to develop OIs decreases by 8.8 (coefficient: -8.8, 95% CI: -16.6, -1.0, p = 0.026) months. Lastly, exposure to undernourishment (intervention) (ratio of average treatment effects to well-nourished potential outcome means in this study was a 32.5% reduction in OIs among adults living with HIV on ART.
conclusionWe found that undernutrition significantly shortened time to develop OIs in adults living with HIV. This implies that the occurrence of OIs in this vulnerable population can be improved through different cost-effective nutritional interventions, such as routine nutritional assessments and education.
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