INTERFACE OF MALNUTRITION AND HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION IN SUB-SAHARAN AFRICA - A CRITICAL-REVIEW

The aggressive campaign of AIDS health education has so far not halted the heterosexual spread of HIV infection. The WHO predicts 14 million cases in Africa by the year 2000. Widespread malnutrition and the traditional tropical pathogens cause mucosal disruptions in the oral cavity and intestine, promote malabsorption of nutrients, and impair various parameters of the immune response. It is therefore not surprising that some clinical features of HIV-infected children in Africa are very similar to those observed in general tropical pediatrics. The relatively short period of clinical latency of HIV-infection in Africa, as well as the severe cachexia and intestinal malabsorption, are largely the consequences of antecedent malnutrition and infestations by other immunosuppressive pathogens prior to the onset of HIV infection. For example, pre-existing malnutrition-induced depletion of cellular GSH and other antioxidant nutrients, promotes rapid transition of HIV-infection through stimulation of HIV replication. control of malnutrition therefore may play a key role in the management of HIV-infection, particularly in impoverished sub-Saharan African countries, by delaying the development of serious opportunistic infections and complications associated with the disease.