Nourishing the HIV-infected adult

Malnutrition of protein, calories, and micronutrients can magnify the immunosuppression of HIV. The goal of nutritional therapy in the HIV-infected population is the maintenance of optimal nutritional status. This may not always be realistic because of the vast number of nutrition-related problems that can occur. In some cases a more appropriate goal is the prevention of further depletion. This is preferably accomplished by intake of a well-balanced diet with the use of a one-a-day type multivitamin if necessary. Tube feedings or parenteral nutrition may be required if oral intake is insufficient. Restricted diets that severely limit food choices may impede adequate intake. Vitamin and mineral megadoses should be avoided because they can impair immunity as well as general biological functioning. The roles of nurses and dietitians are often enmeshed. Nurses are frequently the first to identify nutrition-related problems as part of their daily care of clients. They often augment the nutritional counseling provided by the dietitians. In certain instances, they may be the sole provider of nutrition information. It is therefore important for nurses to have an understanding of the nutritional problems in HIV infection. The responsibility of all health care professionals is the provision of accurate information given in a creative, supportive, and nonjudgmental fashion. This approach can best contribute to patient comfort and health and will foster a trusting and effective relationship.