One of the major clinical manifestations of the acquired immunodeficiency syndrome (AIDS) and AIDS-related complex (ARC) is the development of cachexia. This most likely results from a multifactorial interplay of poor diet, malabsorption, and altered metabolism. To assess the potential role of nutrient intake in the development or persistence of malnutrition, a detailed analysis was performed of a 72-hr diet record in clinically stable patients with AIDS (N = 18), ARC (N = 12) and in human immunodeficiency virus (HIV) seropositive controls without significant manifestations of disease (N = 13). Total calorie intake was 39.1 ± 13.2 kcal/kg/day in AIDS patients vs 34.6 ± 7.8 kcal/kg/day in ARC patients or 31.9 ± 17.7 kcal/kg/day in HIV seropositive cases (all p = NS). Likewise, mean protein intakes were similar among the groups and exceeded recommended daily dietary allowance (RDA) guidelines. The mean body weight changes from the inception of illness were -11 ± 1% in AIDS, -6 ± 7% in ARC, vs +3 ± 2% in HIV-seropositive-only cases (p < 0.05 vs AIDS and ARC). Dietary vitamin and mineral analysis revealed that 88% of AIDS, 88% of HIV seropositive, and 89% of ARC patients were ingesting less than 50% RDA for at least one nutrient. The mean number of deficiencies per patient was 1.8 ± 1.3 in AIDS, 3.8 ± 3.5 in ARC, and 2.9 ± 2.5 in HIV-seropositive-only cases (p < 0.05 AIDS vs ARC). There were no significant correlations between specific anthropometric measurements and dietary intakes of protein or fat. Absolute numbers of CD4 positive peripheral blood lymphocytes did not correlate with weight loss or dietary protein intake. It is concluded that protein and caloric intake in clinically stable AIDS, ARC, and HIV seropositive patients meets RDA standards and is similar among the groups. These data, in this population of patients, could lend further support to the importance of malabsorption or altered metabolism in the development or persistence of cachexia in AIDS. However, the intake of various vitamins and minerals may be inadequate, potentially leading to further compromise of organ functions.
