Elevated highly sensitive C-reactive protein and d-dimer levels are associated with food insecurity among people living with HIV in Pune, India

Sandesh Patil, Dileep Kadam, Nicky Mehtani, Shashikala Sangle, Ivan Marbaniang, Vandana Kulkarni, Dhananjay Shere, Prasad Deshpande, Gauri Dhumal, Nishi Suryavanshi, Nikhil Gupte, Robert C Bollinger, Andrea Deluca, Neetal Nevrekar, Pramila Menon, Rama Kawade, Mansi Patil, Amita Gupta, Vidya Mave

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ObjectiveTo assess the prevalence and determinants of food insecurity among people living with HIV (PLWH) in Pune, India and its association with biomarkers known to confer increased risks of morbidity and mortality in this population.DesignCross-sectional analysis assessing food insecurity using the standardized Household Food Insecurity Access Scale. Participants were dichotomized into two groups: food insecure and food secure. Logistic regression models were used to assess associations between socio-economic, demographic, clinical, biochemical factors and food insecurity.SettingAntiretroviral therapy (ART) centre of Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals (BJGMC-SGH), Pune, a large publicly funded tertiary and teaching hospital in western India.ParticpantsAdult (≥18 years) PLWH attending the ART centre between September 2015 and May 2016 who had received ART for either ≤7d (ART-naïve) or ≥1 year (ART-experienced).ResultsFood insecurity was reported by 40 % of 483 participants. Independent risk factors (adjusted OR; 95 % CI) included monthly family income <INR 5000 (∼70 USD; 13·2; CI 5·4, 32·2) and consuming ≥4 non-vegetarian meals per week (4·7; 1·9, 11·9). High-sensitivity C-reactive protein (hs-CRP) ≥0·33 mg/dl (1·6; 1·04, 2·6) and d-dimer levels 0·19-0·31 μg/ml (1·6; 1·01, 2·6) and ≥0·32 μg/ml (1·9; 1·2, 3·2) were also associated with food insecurity.ConclusionsMore than a third of the study participants were food insecure. Furthermore, higher hs-CRP and d-dimer levels were associated with food insecurity. Prospective studies are required to understand the relationship between food insecurity, hs-CRP and d-dimer better.

Original languageEnglish (US)
JournalPublic health nutrition
StatePublished - Jan 1 2019



  • d-Dimer
  • Food insecurity
  • High-sensitivity C-reactive protein
  • HIV
  • India

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Public Health, Environmental and Occupational Health

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