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Nutritional alterations associated with HIV infection
1Department of Medicine, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, New York 10025, USA. dpkotler@aol.com
Journal of Acquired Immune Deficiency Syndromes (1999)
|December 29, 2000
Summary
Nutritional support in HIV/AIDS can improve weight, but often leads to fat gain. Anabolic agents and exercise are better for rebuilding muscle mass and body cell mass.
Area of Science:
- Nutrition and Metabolism
- Infectious Diseases
- Endocrinology
Background:
- Nutritional deficiencies, including weight loss and protein depletion, were historically prevalent in untreated HIV infection.
- Highly active antiretroviral therapy (HAART) has reduced malnutrition incidence but metabolic issues like altered fat distribution, hyperlipidemia, and insulin resistance persist.
- Malnutrition in HIV/AIDS is complex, involving caloric intake, nutrient absorption, energy expenditure, starvation, cachexia, and hormonal changes like hypercortisolemia and hypogonadism.
Purpose of the Study:
- To evaluate the effectiveness of nutritional interventions in improving the nutritional status of patients with HIV/AIDS.
- To assess the impact of different therapeutic strategies on body composition and metabolic parameters in HIV-infected individuals.
- To explore the clinical benefits of nutritional support and identify optimal treatment approaches for malnutrition in this population.
Main Methods:
- Review of studies on nutritional support, including hypercaloric feeding and appetite stimulants.
- Analysis of research on anabolic agents, resistance training exercise, and cytokine inhibitors for managing wasting.
- Evaluation of combination and preventive therapy approaches.
Main Results:
- Hypercaloric feeding and appetite stimulants can lead to weight gain, primarily as fat mass.
- Anabolic agents and resistance training effectively promote repletion of body cell mass and skeletal muscle.
- Cytokine inhibitors have been investigated as a treatment for HIV-related wasting.
Conclusions:
- Nutritional interventions need careful consideration to optimize body composition changes in HIV/AIDS.
- Strategies focusing on muscle mass and body cell mass repletion, such as anabolic agents and exercise, show promise.
- Further research is needed for developing effective, cost-efficient combination and preventive therapies for malnutrition in HIV/AIDS.