HIV/AIDS Health Article

HIV/AIDS Complications

Some symptoms will require additional attention beyond general nutritional recommendations. For example, diarrhea will rapidly reduce the water content of the body, causing severe alterations in the body's metabolism and electrolyte balance. Electrolytes may be replaced with products such as Pedialyte or Gatorade. Proteins and calories should be increased to prevent weight loss, and dairy products, alcohol, caffeine, and spicy and fatty foods should be avoided.

A second complication is that of weight loss and wasting. According to Derek Macallan, in Wasting HIV Infection and AIDS, wasting may be either acute (associated with a secondary disease) or chronic (associated with gastrointestinal disease), and is the result of a variety of processes, including drug use, medications, concurrent disease, and HIV itself. HIV infection causes abnormal protein and fat metabolism. During episodes of acute wasting the patient may require a prescription for steroids, to help support tissue maintenance and tissue development, in combination with optimal protein and calories in the diet.

Contributing to weight loss and wasting is malabsorption (the failure of nutritional substances to be absorbed in the intestines). Malabsorption occurs in advanced cases of HIV infection when gastrointestinal disease is present. Diseases that can cause malabsorption in HIV/AIDS patients include Kaposi's sarcoma, non-Hodgkin's lymphoma, cytomegalovirus, Myco-bacterium avium complex, and cryptosporidiosis. Malabsorption may require an alternative to oral nutrition.

Alternatives to Oral Nutrition

Alternative routes for nutrition must be considered in patients with fungal growth in the oral cavity, inflammation of the gums and oral mucosa, open sores, difficulty in swallowing, and other debilitating diseases of the oral-pharyngeal region and/or gastrointestinal tract. These alternatives include parenteral (PN) and enteral nutrition. PN replaces essential nutritional requirements via intravenous (IV) access. The IV may be placed in a peripheral vein or in a large central vein, depending on the medical condition of the patient and the choice of nutrition replacement therapy. The cost for PN is high, and there is a risk of severe infection; therefore it is not recommended except for brief treatment measures during known episodic cases of acute weight loss and in the absence of gastrointestinal (GI) function.

Enteral nutrition (placing a tube into the stomach or intestine) is preferred in those patients who have difficulty in swallowing, disease of the oral-pharyngeal region, and adequate GI function. The medical risks with enternal nutrition are less than for PN, but may include injury to the GI tract and infection in the absence safe food practices.