Document 0735
 DOCN  M9460735
 TI    Nutrition support and the human immunodeficiency virus (HIV).
 DT    9404
 AU    Bell SJ; Mascioli EA; Forse RA; Bistrian BR; Surgical Metabolism
       Laboratory, Deaconess Hospital, Boston, MA; 02215.
 SO    Parasitology. 1993;107 Suppl:S53-67. Unique Identifier : AIDSLINE
       MED/94159384
 AB    Nutritional support of patients with HIV or acquired immune deficiency
       syndrome (AIDS) has many similarities to other disease states in that
       the same nutritional products and techniques are used. Some patients
       with HIV, and many with AIDS without secondary infection, experience a
       metabolic milieu similar to patients with cancer cachexia. In providing
       dietary counselling to the HIV patient, we encounter many of the
       obstacles that must be overcome to improve nutrition in cancer:
       anorexia, gastrointestinal discomfort, lethargy, and poor nutrient
       utilization, which limit the ability for nutritional repletion. When a
       secondary infection is superimposed on HIV, patients resemble more
       highly catabolic trauma patients or patients in the intensive care unit
       (ICU), where, despite aggressive efforts to feed, there is usually a net
       nitrogen wasting leading to the more rapid development of cachexia.
       However, even in this setting, feeding will limit substantially net
       catabolism when compared to total starvation. Because the nutritional
       needs of HIV patients vary greatly, individual strategies have to be
       designed as the patient moves through the stages of disease. Patients
       are generally able to consume adequate nutrition either as regular food
       or dietary supplements during the latency period of viral replication.
       Once secondary infections become prevalent, artificial diets
       administered by tube or by vein may be required during the period of
       active secondary infections, with dietary supplements often helpful
       during more quiescent periods. Patients with HIV are among the most
       challenging for clinicians providing nutritional support. Knowledge from
       treatment of patients with other diseases may be useful, but more data
       must be gathered on the unique aspects of aetiology and treatment of the
       anorexia, malabsorption, and ultimate wasting associated with AIDS.
 DE    Acquired Immunodeficiency Syndrome/COMPLICATIONS/DIET THERAPY/
       PHYSIOPATHOLOGY  Body Composition  Energy Metabolism  Enteral Nutrition
       Human  HIV Infections/COMPLICATIONS/*DIET THERAPY/PHYSIOPATHOLOGY
       Lipids/METABOLISM  Nutrition Disorders/*DIET
       THERAPY/EPIDEMIOLOGY/ETIOLOGY/  METABOLISM  Parenteral Nutrition
       Prevalence  Support, Non-U.S. Gov't  JOURNAL ARTICLE  REVIEW  REVIEW,
       TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).