1. HIV and AIDS

2. 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

3. 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
Goal: maintain or restore nutritional status
Weight maintenance
Inflammatory state: breaks down protein stores  wasting

4. Nutrition Therapy Nutritional Implications
Reduction in muscular protein influenced by medications
Calories, protein
Changes in macro- and micronutrient status
Lower serum selenium, zinc, magnesium, calcium, iron, manganese, copper, carotene, choline, glutathione, vitamins A, B6, B12, E
Carnotene: helps process fats/lipids

5. Nutrition Therapy Nutritional Assessment
Nutritional risk screening and follow-up assessment for identified risk factors
Physical, biochemical, nutrition-related factors, social factors

7. Nutrition Therapy Nutritional Assessment Physical
BMI less than 20 we would start looking at parentral nutrition
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
CT scan, underwater weight, fat folds, bioelectric competence

8. Abdominal circumference
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9. Abdominal skinfold

10. Right side skinfold
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11. Back skinfold
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12. Infraorbital skinfold
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13. Buccal skinfold
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14. Sub-mandibal skinfold
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16. Nutrition Therapy Biochemical Assessment Viral load CD4 count CRP
Albumin
Concerned about protein
Liver function tests
Medications effect their liver
Look at stage they’re in
Renal function tests
Insulin, blood sugar
Hormone levels

19. 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

20. Nutrition Therapy Dietary Evaluation Food behaviors Food security
Food intake
Compare with estimated needs for fluids, protein, micronutrients
Need for food and nutrient supplements

21. Nutrition Therapy Nutrition Interventions Macronutrient Therapy
Fluid based on hydration maintenance
Kcal based on balance for healthy weight
Protein recommendations usually higher

24. © 2007 Thomson - Wadsworth

27. Nutrition Therapy Symptom management Fatigue and diarrhea most common
Anti-diarrheals
Pancreatic or lactase enzymes
Supplementation of nutrients as pharmaceutical agents