Nutrition and HIV

Today over 40 million adults and children worldwide are infected
with HIV, however knowledge of the disease has increased greatly
and the prognosis is now good for those with access to
anti-retroviral treatment.

For many, HIV is now a long-term chronic condition and with
decreased mortality, patient requirements and disease patterns have
changed, making it increasingly apparent to health care
professionals that the treatment of HIV should include optimum
nutrition and healthy lifestyle interventions to help sufferers
lead long and healthy lives.

In this essential new book an international team of authors
under the editorship of Specialist HIV Dietitian Vivian Pribram
bring together the latest research to provide the practicing
dietitian and nutritionist with a practical guide to the
nutritional care of the HIV and AIDS patient. Students and other
health care professionals working and studying this area will also
find Nutrition and HIV an important and valuable
resource.

Auteur

Vivian Pribram, Specialist Dietitian, King's College
Hospital, London, UK

Résumé
Today over 40 million adults and children worldwide are infected with HIV, however knowledge of the disease has increased greatly and the prognosis is now good for those with access to anti-retroviral treatment. For many, HIV is now a long-term chronic condition and with decreased mortality, patient requirements and disease patterns have changed, making it increasingly apparent to health care professionals that the treatment of HIV should include optimum nutrition and healthy lifestyle interventions to help sufferers lead long and healthy lives.

In this essential new book an international team of authors under the editorship of Specialist HIV Dietitian Vivian Pribram bring together the latest research to provide the practicing dietitian and nutritionist with a practical guide to the nutritional care of the HIV and AIDS patient. Students and other health care professionals working and studying this area will also find Nutrition and HIV an important and valuable resource.

Contenu

List of Contributors xiv

Preface xviii

Acknowledgements xix

SECTION 1: INTRODUCTION

1 Introduction to Human Immunodeficiency Virus 3
Tanya Welz, Amanda Samarawickrama, Vivian Pribram, Bavithra Nathan, Lisa Hamzah and Emily Cheserem

1.1 Introduction 3

1.2 Current state of the epidemic 4

1.3 HIV transmission 5

1.4 About the virus 6

1.5 Diagnosis of HIV 8

1.6 Measurement of CD4 cells 8

1.7 Natural history of untreated HIV infection and AIDS 10

1.8 Staging and classification of HIV disease 10

1.9 Monitoring the HIV pandemic 12

1.10 Prevention 13

1.11 Effect of antiretroviral therapy on the HIV epidemic 14

1.12 Stigma 14

2 Introduction to Nutrition and HIV 18
Vivian Pribram

2.1 Introduction 18

2.2 Malnutrition, infectious disease and immune function 19

2.3 HIV infection and decreased nutritional status 21

2.4 Nutritional screening and assessment 22

2.5 Metabolic and morphological complications 23

2.6 Paediatric undernutrition and maternal and child health 24

2.7 Healthy eating and management of HIV for well-being and longevity 26

2.8 Management of co-morbidities and serious non-HIV conditions 27

2.9 End-of-life care and ethical issues 29

SECTION 2: PAEDIATRIC NUTRITION, MATERNAL AND CHILD HEALTH

3 Malnutrition, Infant Feeding, Maternal and Child Health 35
Theresa Banda, Vivian Pribram, Margaret Lawson, Catherine Mkangama and Gertrude Nyirenda

3.1 Introduction 35

3.2 Maternal health and nutrition 36

3.3 Mother-to-child transmission 41

3.4 Infant feeding in the context of HIV 43

3.5 Malnutrition in children with HIV 49

4 Paediatric Nutritional Screening, Assessment and Support 58
Lisa Cooke

4.1 Introduction 58

4.2 Nutritional assessment and screening 58

4.3 Dietary assessment what to do 61

4.4 Nutritional support 68

5 Adherence, Symptom Management, Psychological Aspects and Multidisciplinary Care of Children with HIV 72
Daya Nayagam, Paul Archer, Susheela Sababady, Shema Doshi, and Ella Sherlock

5.1 Transmission of HIV in children and young people 72

5.2 Prevention of mother-to-child transmission (vertical transmission) 73

5.3 Clinical presentation of paediatric HIV infection 73

5.4 Failure to thrive 73

5.5 Central nervous system 74

5.6 Hepatosplenomegaly 74

5.7 Older children 74

5.8 HIV disease and opportunistic infections 74

5.9 Prophylaxis 74

5.10 Antiretroviral treatment for children 75

5.11 Monitoring of paediatric HIV infection 77

5.12 Caring for children and their families in the community 77

5.13 Adherence, symptom management, psychological aspects and multidisciplinary care of children with HIV and AIDS 78

5.14 Nutritional care in a multidisciplinary team setting 81

5.15 The psychological effects of HIV on family functioning key themes which arise in a child setting 82

6 Healthy Eating, Prevention and Management of Obesity and Long-Term Complications in Children 87
Julie Lanigan

6.1 Introduction 87

6.2 Metabolic complications 88

6.3 Malnutrition and HIV 88

6.4 Micronutrients and HIV 88

6.5 Obesity 90

6.6 Lipodystrophy 91

6.7 Assessment and monitoring 94

6.8 Dietary intake assessment 94

6.9 Advice for healthy eating 94

6.10 Conclusion 100

SECTION 3: NUTRITIONAL MANAGEMENT OF HIV DISEASE

7 Decreased Nutritional Status and Nutritional Interventions for People Living with HIV 107
Vivian Pribram 7.1 Introduction/Background 107&l...