Nutrition for Special Groups

Nutrition for Special Groups 3(3+0)

Lesson 47 : Hiv Aids

Importance of Malnutrition and Wasting in HIV/AIDS

The interaction between malnutrition and HIV is complex. Recognizing malnutrition is important because it may predict disease progression and higher risk of morbidity and mortality. The presence of malnutrition is a predictor of worse outcomes in both HIV-infected adults and children. In HIV-infected children, measurements such as height growth velocity and low weight for age predict survival and disease progression. Malnutrition may be a secondary result of advanced HIV disease. Primary malnutrition may also accelerate HIV disease progression. Malnutrition independent of HIV infection has a high morbidity and mortality, and this effect may be exaggerated in HIV-positive individuals.

Recognizing malnutrition is also important so that specific treatments directed at improving nutritional status can be used. Control of HIV infection using antiretroviral (ARV) medications and interventions directed at nutritional deficiencies, such as nutritional supplements, are often both necessary to adequately care for infected individuals. Use of ARVs without nutritional support, or nutritional support without ARVs, will often result in poor treatment responses and outcomes. With ARV medications and improvement in CD4 count and viral load, weight and some lean body mass can be restored. However, some patients see little to no improvement in lean body mass, so one must try to maintain good nutritional status in HIV-positive patients from the time of diagnosis.