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NUTRITION AND HIV/AIDS: Evidence, Gaps, and Priority Actions

Source: www.fantaproject.org
Topic: Hiv/Aids
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Sort Desciption: In Africa, where more than 25 million people are living with HIV/AIDS, malnutrition and food insecurity are endemic. Today, nearly 40% of African children < 5 years old are stunted due to chronic nutritional deprivation. ...

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In Africa, where more than 25 million people are living with HIV/AIDS, malnutrition and food insecurity are endemic. Today, nearly 40% of African children < 5 years old are stunted due to chronic nutritional deprivation. 1 Underweight, an indicator of chronic and acute malnutrition, was the leading cause of mortality worldwide, responsible for 3.7 million deaths in 2000. 2 Nearly half of these deaths (48.6%) occurred in sub-Saharan Africa. The effects of malnutrition on the immune system are well known and include decreases in CD4 Tcells, suppression of delayed hypersensitivity, and abnormal B-cell responses. 3-4 The immune suppression caused by protein-energy malnutrition is similar in many ways to the effects of HIV infection. 5 This document summarizes the evidence, gaps, and priority actions related to nutrition and HIV/AIDS. Nutrition and HIV/AIDS: The Evidence and Gaps HIV infection increases energy requirements . HIV infection affects nutrition through increases in resting energy expenditure, reductions in food intake, nutrient malabsorption and loss, and complex metabolic alterations that culminate in weight loss and wasting common in AIDS. 6-7 The effect of HIV on nutrition begins early in the course of the disease, even before an individual may be aware that he or she is infected with the virus. 8-10 Asymptomatic HIV positive individuals require 10% more energy, and symptomatic HIV-positive individuals require 20%30% more energy than HIV-negative individuals of the same age, sex, and physical activity level. 11 The impact of pre-existing malnutrition on HIV susceptibility and disease progression is difficult to study, and knowledge in this area is still limited. A systematic review of the literature is now underway by the World Health Organization (WHO). 11 Early studies demonstrated that weight loss and wasting were associated with increased risk of opportunistic ...

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