Figure 2. Risk factors for individual and multiple micronutrient deficiencies pre-ART initiation.

Independent risk factors for vitamin A, B₆, B₁₂ and multiple (≥3 concurrent deficiencies) micronutrient deficiencies. Odds ratio (■) with 95% confidence intervals (CI) are shown only for variables with significant (based on CI) odds of deficiency in multivariable logistic regression models adjusting for gender, country, BMI, CD4 count, log viral load and CRP. Multiple micronutrient deficiencies were defined as deficiency in three or more micronutrients when considering vitamins A, B₆, B₁₂, D, E, selenium, iron and low total carotenoids. High CRP is defined as CRP levels ≥5 mg/L with low CRP as the reference group. Low body mass index (BMI) is defined as BMI <18.5 kg/m² with normal BMI (18.5–25 kg/m²) as the reference group. CD4 categories with counts of 200–300 cells/mm³ were the reference group for CD4 count and viral load categories with log viral load less than 4 copies/mL were the reference group for viral load. For vitamin A, B₆, B₁₂ and multiple deficiencies, the reference countries were Thailand, South Africa, Peru and Haiti, respectively. The country with the lowest non-zero prevalence of deficiency was chosen as the reference country for each micronutrient. Deficiencies are based on cutoffs used in Table 1.