HIV and AIDS

KNH 406

HIV/AIDS

HIV - virus that targets host immune cells and turns

them into viral factories for HIV reproduction

AIDS - associated symptomatic condition rendering the

host vulnerable to opportunistic infections, disability,

death

Nutrition Therapy

Nutritional Implications

AIDS-related wasting syndrome (AWS)

Changes in body composition during weight loss

like starvation or marasmus

Weight loss or wasting even with adequate or

increased kcal intake, may be immune mediated

Decrease in LBM even without weight loss

Nutrition Therapy

Nutritional Implications

Reduction in muscular protein influenced by medications

Changes in macro- and micronutrient status

Lower serum selenium, zinc, magnesium, calcium, iron,

manganese, copper, carotene, choline, glutathione, vitamins A,

B6, B12, E

Nutrition Therapy

Nutritional Implications

Low levels of B12

Bone marrow toxicity if taking zidovudine

Oxidative stress

Nutrition Therapy

Nutritional Assessment

Nutritional risk screening and follow-up assessment for

identified risk factors

Physical, biochemical, nutrition-related factors, social

factors

© 2007 Thomson - Wadsworth

Nutrition Therapy

Nutritional Assessment

Physical

Weight

Body composition

Assess causes of weight loss and body composition changes

without weight loss

Total volumes of body compartments and patterning of fat tissue

© 2007 Thomson - Wadsworth

Abdominal circumference

© 2007 Thomson - Wadsworth

Abdominal skinfold

© 2007 Thomson - Wadsworth

Right side skinfold

© 2007 Thomson - Wadsworth

Back skinfold

© 2007 Thomson - Wadsworth

Infraorbital skinfold

© 2007 Thomson - Wadsworth

Buccal skinfold

© 2007 Thomson - Wadsworth

Sub-mandibal skinfold

© 2007 Thomson - Wadsworth

Nutrition Therapy Biochemical Assessment

Viral load

CD4 count

CRP

Albumin

Liver function tests

Renal function tests

Insulin, blood sugar

Hormone levels

© 2007 Thomson - Wadsworth

Nutrition Therapy Medical History Assessment

Current and past medical conditions

Hx of nutrition problems

Concomitant diseases

Use of herbal and OTC meds

Potential drug-nutrient interactions

Nutrition Therapy Dietary Evaluation

Food behaviors

Food security

Food intake

Compare with estimated needs for fluids, protein,

micronutrients

Need for food and nutrient supplements

Nutrition Therapy Nutrition Interventions

Macronutrient Therapy

Fluid based on hydration maintenance

Kcal based on balance for healthy weight

Protein recommendations usually higher

© 2007 Thomson - Wadsworth

Nutrition Therapy Symptom management

Fatigue and diarrhea most common

Anti-diarrheals

Pancreatic or lactase enzymes

Supplementation of nutrients as pharmaceutical agents

Nutrition Therapy Nutrition Care Process

Prioritize most urgent issues

Intervention goals

Coordination of services and products

Routine appointments to monitor and evaluate plan