AIDS

1
AIDS

• FCS 4751
• M.Burns

2
Evolution of HIV

• 1981
• 1985
• 1987
• 1990
• 1991-1992
• 1995

3
CDC Reports...

• 53 of cases due to male-male contact
• 25 IV drug use
• 49 white, 33 black, 17 Hispanic
• Numbers are doubling every 2 yrs.

4
Disease Progression

• Primary HIV infection
• Extended asymptomic incubation
• AIDS-related complex
• Opportunistic infections
• Symptoms occur

5
Disease Progression

• Final Stage
• Terminal
• Kaposis sacroma
• AIDS dementia

6
Medical Tx Goal

• Eliminate, or suppress, the virus
• Medical tx objectives
• Evaluation of pt
• Education
• Drug therapy
• Regular F/Us

7
MNT Goals

• Provide adequate nutrition for MTN or improvement
  of nutl status.
• Prevent PEM and vitamin/mineral deficiencies.
• Provide nutrition education

8
Nutrition Assessment

• Antropometrics
• Body fat not a good indicator.
• Compare weight loss to UBW
• Biochemical
• alb, prealb, TF, TIBC - indicated
• TLC and skin testing - contraindicated

9
Nutrition Assessment

• Clinical
• Signs of vitamin/mineral deficiencies
• Signs of Kaposis sacroma
• Signs of oral candidiasis
• Signs of AIDS dementia

10
Nutrition Assessment

• Dietary
• Diet hx, usual intake, intolerances
• Supplements?
• Eating habits
• PEM is very common.

11
Nutrition Assessment

• Emotional
• Living situation, support system, anxiety,
  depression
• Financial
• Medical insurance, income, expenses

12
Nutrition Therapy

• All pts are at high nutl risk.
• HIV wasting syndrome
• Caused more from poor intake.
• Involuntary wt loss of gt10 in one month.
• Wasting begins early in the disease progression.

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Nutritional Needs

• Energy
• Protein
• Fat
• Fluid
• Vitamins/minerals

14
Nutritional Complications

• Reduced food intake
• N/V, stomatis, dysphagia, dysgeusia
• Accelerated nutrient losses
• AIDS enteropathy, drug tx, malabsorption
• Altered metabolism
• infections, CA, drug tx

15
HIV/AIDS in children

• Nutrition assessment
• Nutrient needs
• Psychosocial considerations
• Feeding skills