Introduction
Nutrition may be a cofactor in HIV progression.
1) Poor nutritional status and infection affect the immune system and interact with each other.
2) Development of opportunistic infection and malignancies.
Malnutrition is a very serious problem in AIDS, since the timing of death is directly related to the degree of body mass depletion and is independent of the underlying cause of wasting.When wasting of lean body mass approaches 55% of normal, death is imminent. This occurs independently of the reason for weight loss.“Slim Disease” - Earliest cases in Uganda, in late 1970s, characterized by unexplained wasting.In AIDS, CACHEXIA is present. There is a loss in lean body mass. Superimposed on this may be starvation, a loss of body fat mass.
Malnutrition Causes Infections
Protein-calorie malnutrition (PCM) causes depression of cellular immunity with abnormal T cell and macrophage function. This could theoretically worsen the immunodeficiency of people with AIDS, making them more susceptible to infection and worsening existing infections. Virulence may be influenced by a host’s nutritional state. Malnutrition may contribute to life-threatening infectious disease.
Infection Causes Malnutrition
1) Alters absorption and availability of nutrients
2) Alters hormone secretion, liver synthesis of acute-phase reactant proteins
3) Increases gluconeogenesis/lipogenesis
4)Most infections alter carbohydrate, lipid and protein metabolism, electrolyte balance, trace mineral/vitamin levels
5) Fever increases caloric requirements. Each degree rise increases caloric needs by 7%.
