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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
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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
Recommended