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

Affects of HIV/AIDS on Nutrition• Decrease in the amount of foodconsumed• Impaired nutrient absorption• Changes in metabolismCauses of DecreasedFood Consumption• Mouth and throat sores• Loss of appetite leading to fatigue,depression, and changes in mental state• Side effects from medication• Abdominal pain• Household food insecurity and povertyPoor Nutrient Absorption• Nutrient absorption impaired during manyinfections• Poor absorption of fats and carbohydratesat all stages of HIV infection because of− HIV infection of intestinal cells− Frequent diarrhea and vomiting− Opportunistic infections• Poor absorption of fats that affects use offat-soluble vitamins such as A and EChanges in Metabolism• Infection increases energy (10%-15%) andprotein (50% or more) requirements• Infection increases demand for andutilization of antioxidant vitamins (E, C,beta-carotene) and minerals (zinc,selenium, iron)• Insufficient antioxidants from increasedutilization causes oxidative stress− Increases HIV replication− Leads to higher viral loadsHIV-Associated Wasting SyndromeBody weight is the most common bodycomposition measurement but isinaccurate because of:• Fluid overload (e.g., severe renal disease,IV rehydration)• Fluid deficits (e.g., dehydration fromdiarrhea, poor fluid intake)• Inability to differentiate between changesin lean tissues or fatHIV-AssociatedWasting Syndrome, Cont.Body cell mass is superior to body weight• Measures the metabolically active tissue compartment in thebody• Includes the muscles, organs, and circulating cells and so candifferentiate between lean tissues and fatStudies show• Progressive depletion of body cell mass in the late stages ofHIV disease (Kotler 1985)• Significant prolonged survival in patients with body cell mass>30% of body weight or serum albumin levels exceeding3.0g/dl (Suttman 1991)