NUTRITION AND HIV-INFECTION

Human immunodeficiency virus (HN) infection and the development of AID S (acquired immunodeficiency syndrome) is beginning to be appreciated as a chronic, progressive disease. The impact of this disease on nutri tional status is manifested most blatantly in the ''wasting syndrome,' ' but is seen in the vast majority of patients to a lesser extent. Wha t is perhaps not as well recognized is the impact of malnutrition on t he underlying immune competence of the individual and on the course of the HN infection. The causes of malnutrition in this population are r elated to decreased nutrient intake, malabsorption, and altered metabo lism in the setting of chronic HIV infection as well as intercurrent s econdary infection. Management strategies for the treatment of malnutr ition in patients with HN infection should include, at a baseline, a h igh index of suspicion and early recognition of malnutrition. Processe s underlying the development of malnutrition must be sought out and tr eated if possible. The goals of nutritional intervention should be to preserve lean body mass and provide adequate nutrients as well as to m inimize symptoms of malabsorption and improve quality of life. Options for specific nutritional therapy range from oral supplements to home TPN (total parenteral nutrition) and this must be individualized for e ach patient.