An assessment of the need for a dietitian in an out-patient HIV clinic

People suffering from the acquired immunodeficiency syndrome (AIDS) often experience involuntary weight loss and malnutrition. Altered body composition, recurrent opportunistic infection and a decline in immune function are associated with the progression of the human immunodeficiency virus (HIV) infection to AIDS. The factors that might affect nutritional status in AIDS are numerous and include a reduced food intake, increased metabolism, malabsorption and the acute phase response to infection. It is not clear what difference nutritional intervention can make to the progression of the disease. However, there is a consensus that it has an important role to play during the course of the disease. A report was compiled to assess the requirement for a dietitian in an HIV Clinic (the Southern Alberta Clinic) and the role of the dietitian in that position. Nutritional and anthropometric data were collected from medical records. In addition, Clinic physicians were sent a questionnaire. It was found that clients, when seen by the dietitian, had lost weight and had more gastrointestinal symptoms and a lower CD4+ lymphocyte count than the average Clinic patient at their initial Clinic visit. The report recommended that all Clinic staff use body mass index as a screening tool for referral to the dietitian and that good nutrition be promoted by the Clinic as an important part of the care of the HIV infected person. The assessment recommended a 0.4 full-time equivalent position within the Southern Alberta Clinic.