Please enable JavaScript.
Coggle requires JavaScript to display documents.
PHYSIOLOGY:HIV & NUTRITION - Coggle Diagram
PHYSIOLOGY:HIV & NUTRITION
Old era
Undernutrition & wasting incl. late presentation of AIDS
Approaches>avoid malnutrition , delay breastfeeding, therapy adjustment
ARVs started when clinically indicated
HIV Malnutrition
HIV enteropathy:↓ intake(Loss of Appetite) & absorption(diarrhoea)
made worse by OIs + ARV side effects
Requires ↑ energy & nutrients
Difficulty in chewing , swallowing ,procuring , preparing
New era
Improved immunosuppression & PMTCT
↑ risk of NCD , ↑ lifespan, obesity +metabolic complications
↑ ARV rollout
2 Types of Weight loss
Starvation: Lack of nutrients due to ↓ intake, malabsorption/↑losses
Cachexia:Loss of Lean body mass(muscles) due to altered metabolism
HIV Malnutrition flow chart
HIV Wasting Sydromes
involuntary 10% weight loss
Diarrhoea>1 month
Weakness>1 month
Not having other condition(eg TB)
Metabolic Complications
Disease & Drug related
Dylipidaemia from protease inhibitors(PIs)
Manifestation varies
Insulin resisatnce from PIs & NRTIs
high risk of obesity
Lipodystrophy
Lipohypertrophy=abnormal accumulation of fat(visceral fat cental adiposity , dorsocervical fat pad & breast)
Peipheral subcutaneous Lipoatrophy: loss of fat(appendices & face , rare with newer ARVs)
Nutritional Therapy Goals
Prevent rather than reverse, maintain LBM,Maintain normal body weight,prevent comorbidies
↓ HIV symptoms,↑ adherence,manage metabolic complications,improve quality of life