HIV/AIDS and Nutrition

Jeanne Garber
MS,RD,LN
Yellowstone City-County Health
Department
 HIV and Aids 2002

World United
States
Living with HIV or Aids 42,000,000 850,000

Newly infected with HIV 5,000,000 40,000

Aids Deaths 3,100,000 14,500

 Bringing a new perspective to the international AIDS crisis.

37,800,000 people living with HIV/AIDS globally at the end of 2003

35,000,000 people who travel to Las Vegas every year

26,900,000 people living with AIDS in developing countries

27,000,000 people reached by Yahoo News and Google News

4,800,000 new infections globally in 2003:

4,900,000 Americans who had non-surgical cosmetic procedures in
2002

2,900,000 people globally who died of AIDS in 2003

2,200,000 people in SubSaharan Africa who died of AIDS in 2003

18,144,000 women living with HIV/AIDS globally

18,000,000 Americans living with diabetes
 14,250,000: women living with HIV/AIDS in sub-Saharan
Africa
200,000: women living with HIV/AIDS in North America

12,000,000: (Estimated) children in SubSaharan Africa

who have lost one or both parents to AIDS
18,400,000: children worldwide expected to have lost
parents to HIV/AIDS by 2010

25,000,000: people in SubSaharan Africa living with

HIV/AIDS at the end of 2003
7,400,000: Asians living with HIV/AIDS at the end of
2003
1,300,000: people in Eastern Europe and Central Asia
living with HIV/AIDS
950,000: people living with AIDS in the United States
 Classification
HIV positive is when a person is infected
with the virus
AIDS: CD4 cells less than 500 with an
opportunistic disease.
 Nutritional risk
HIV-infected patients may be at nutritional
risk at any point in their illness
Delayed weight gain in children
Weight loss
Loss of lean tissue
Severe malnutrition
Developing fat-redistribution syndrome
Diabetes heart disease and stroke
 Nutrition Education
Healthful dietary principles
Maintain lean body mass
Drug therapies
Drug/nutrient interactions
Gastrointestinal interactions
Herbal and/or nutritional supplements
Exercise
Substance Abuse
Food Safety
Healthful Dietary Principles
Healthy lifestyle changes.
5-9 fruits and vegetables.
Increasing fiber
Limit fat to 30 % of total
calories
Exercise
 Lean Body Mass
Height
Weight: usual, current, and ideal
Triceps Skin Fold
BMI
Bioelectric Impedance Analysis (BIA)
 Drug Therapies
Three types of drug therapies
1. Nucleoside Reverse Transcriptase Inhibitors
2. Non-nucleoside Reverse Transcriptase
Inhibitors
3. Protease Inhibitors
 Food/Drug Interactions
Calorie, protein and fat recommendations
Barriers and solutions to meeting food
requirements for medications
Antacids
 Herbal Products
Cats claw, chamomile, echinacea, goldenseal
inhibition of CYP3A4
St. Johns wort decreases levels of indinavir and
cyclosporine
Ginkgo, Dong quai, and ginseng increases INR
when combined with warfarin
Ephedra: toxicity when combined with caffeine
and other stimulants
Glucosamine: decreased glucose tolerance
 Supplements
General recommendations
Multivitamin w/o extra iron
Vitamin E if taking drugs toxic to the bone
marrow. Not for anyone taking Agenerase
Correct Vit. A deficiencies can increase CD4
counts. Best to do so by food.
Vit B 12 associated with dementia,
neuropathy, and are at risk due to diarrhea.
Vit. B complex take 2 times daily
 Supplementation
Vit. C: in smokers with ppd hx > 15 years
500mg bid. Not more than 3g/day
Alcohol: Vit.A, B12, B-complex and
thiamine deficiencies. Also nutrient
deficient due to poor diet.
Substance abuse: Zinc, Vit. C, Vit A-
through diet. Assess dietary intake.
 GI interactions
Many meds particularly protease
inhibitors, cause diarrhea
Nausea/vomiting can occur when starting
HAART meds, or w/o adequate food
GERD: triggered by caffeine, alcohol,
citrus, tomatoes, mint, garlic and onions
 Diet and Exercise
Reduce lipodystrophy
Reduce triglyceride levels
Reduces other side effects due to HIV
medications
 Substance Abuse
Poor food intake
Zinc deficiency
Low levels of vitamins A, C and E
 Food Safety
Food and waterborne diseases
Diarrhea
Enteric Infections
Salmonellosis
Listeriosis
Vibro vulnificus: Oysters, shellfish