Nutrition and HIV/AIDS: A Training Manual - Linkages Project

Seroconversion. During the seroconversion phase, the body produces antibodies tofight the virus. The body needs additional energy and nutrients to mount thisimmune response. If these are not provided by the diet, the host will use fat andmuscle to provide the necessary nutrients. The host will lose weight and willgradually develop malnutrition that will weaken the immune system and make thehost vulnerable to opportunistic infections. The seroconversion phase occurs after 6–12 weeks.II. Asymptomatic phaseThe length of the asymptomatic phase varies and may last several years, dependingon the host’s health and nutritional status before the infection. The asymptomaticphase is marked by hypermetabolism and increased energy needs.III. Symptomatic phase (slide 6)Initial symptoms are marked by the onset of opportunistic infections. Commonsymptoms include fever, night sweats, tuberculosis, fungal infection of the mouth,chronic diarrhea, and weight loss. The onset of opportunistic infections is a sign of aweakened immune system. Negative nitrogen balance occurs early in acuteinfections because of the decrease in food intake and increased urinary proteinlosses. Immunologic response to infection activates cytokines, which causes feverand anorexia, thereby leading to increased energy expenditure and decreasedcaloric intake. The opportunistic infections further increase the nutritional needs ofthe host and continue to weaken the immune system and hasten the progression ofthe disease.The persistence of symptoms and opportunistic infections lead to increased energy,and nutrient needs, reduced food intake, malabsorption of nutrients, weight loss,and wasting. Wasting is defined as a profound involuntary weight loss > 10 percent ofbaseline body weight plus either chronic diarrhea (> 30 days) or chronic weaknessand documented fever (> 30 days) in the absence of a concurrence illness orcondition other than HIV infection (Macallan 1999). Wasting is often accompanied bychanges in lean body mass and body cell mass (Babameto and Kotler 1997). Thepersistence of reduced food intake, malabsorption of nutrients, weight loss, andwasting will lead to full-blown AIDS.104