Combating malnutrition in HIV infection

Physicians should use nutrition as adjunctive therapy for all patients affected by HIV disease. However, when wasting is already present, a thorough evaluation (examination and labs) to elucidate and treat the underlying causes of malnutrition should be initiated, dietary counseling made available, and nutritional and vitamin/mineral supplementation encouraged. Appetite stimulants may be helpful when appropriate. If wasting syndrome develops despite intervention, enteral or parenteral nutrition may be considered. Clinical trials are currently underway to assess the utility of anabolic therapies and cytokine inhibitors as additional options. Malnutrition is a leading cause of morbidity in HIV disease. With continued research and early nutritional interventions (i.e., prevention as well as treatment strategies), the task of preventing wasting may eventually become "a piece of cake."