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Repeated Assessments of Food Security Predict CD4 Change in the Setting of Antiretroviral Therapy

McMahon, James H MBBS, MPH*†; Wanke, Christine A MD; Elliott, Julian H MBBS, PhD*‡§; Skinner, Sally MA; Tang, Alice M PhD

JAIDS Journal of Acquired Immune Deficiency Syndromes: September 1st, 2011 - Volume 58 - Issue 1 - p 60-63
doi: 10.1097/QAI.0b013e318227f8dd
Brief Report: Clinical Science

Food insecurity is highly prevalent in HIV-infected populations, and analyses utilizing multiple assessments of food security to predict CD4 change are lacking. Five hundred Ninety-two patients with ≥ 4 food security assessments were followed prospectively. In the final model, for patients using antiretroviral therapy, increases in CD4 counts were on average 99.5 cells less for individuals with at least 1 episode of food insecurity compared with those consistently food secure (P < 0.001). Other sociodemographic factors were not predictive. Repeated assessments of food security are potent predictors of treatment response notwithstanding antiretroviral therapy use. Potential mechanisms for this association are proposed.

From the *Department of Infectious Diseases, Alfred Hospital, Melbourne, Australia; †Department of Public Health and Community Medicine, Nutrition/Infection Unit, Tufts University School of Medicine, Boston, MA; ‡Department of Medicine, Monash University; and §Burnet Institute, Melbourne, Australia.

Received for publication March 28, 2011; accepted June 6, 2011.

Supported by National Institutes of Health (R01 HL 65947, P30DA13868, P30 AI42853, P01 DK45734), National Health and Medical Research Council (Postgraduate Scholarship to J.H.M).

Presented in part as an abstract at the 18th International AIDS Conference, 2010, Vienna, Austria, as “J. McMahon, et al. Associations between history of food security, body mass index and immunological response”. Abstract no. CDC0264.

The authors have no conflicts of interest to disclose.

Correspondence to: James McMahon, MBBS, MPH, Infectious Diseases Unit, Alfred Hospital, Level 2 Burnet Tower, 85 Commercial Road, Melbourne, Australia 3004 (e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.