NUTRITION AND HIV-INFECTION

Human immunodeficiency virus (HN) infection and the development of AIDS (acquired immunodeficiency syndrome) is beginning to be appreciated as a chronic, progressive disease. The impact of this disease on nutritional status is manifested most blatantly in the ''wasting syndrome,'' but is seen in the vast majority of patients to a lesser extent. What is perhaps not as well recognized is the impact of malnutrition on the underlying immune competence of the individual and on the course of the HN infection. The causes of malnutrition in this population are related to decreased nutrient intake, malabsorption, and altered metabolism in the setting of chronic HIV infection as well as intercurrent secondary infection. Management strategies for the treatment of malnutrition in patients with HN infection should include, at a baseline, a high index of suspicion and early recognition of malnutrition. Processes underlying the development of malnutrition must be sought out and treated if possible. The goals of nutritional intervention should be to preserve lean body mass and provide adequate nutrients as well as to minimize symptoms of malabsorption and improve quality of life. Options for specific nutritional therapy range from oral supplements to home TPN (total parenteral nutrition) and this must be individualized for each patient.