Human Immunodeficiency Virus (HIV) is a type of retrovirus that principally attacks CD4 T-cells, a vital part of the human immune system, and causes acquired immunodeficiency syndrome (AIDS). Acquired immunodeficiency syndrome (AIDS) surfaced in the US in the 1980s. Recognized as the terminal stage of an infection caused by the human immunodeficiency virus (HIV), AIDS can strike any age, sex, all age groups, and nationalities. The body’s ability to resist opportunistic viral and other infections is greatly weakened. HIV can be transmitted sexually; through contact with contaminated blood, tissues, or needles; and from mother to child during birth or breastfeeding. The late stage of HIV infection attacks organ systems of the body and develops into AIDS and opportunistic infections such as Kaposi’s sarcoma, pneumonia, candidiasis, and tuberculosis. Neurological complications and dramatic weight loss, or “wasting”, are the characteristic of the end-stage.

Despite effective antiretroviral treatments that are currently available, HIV-infected individuals face lifelong medications to control HIV and wasting. Nutrition intervention is necessary at all stages of therapy. The general nutrition goals when caring for a person with HIV infection are 1) to preserve lean body mass; 2) to provide adequate amounts of all nutrients; 3) to minimize gastrointestinal (malabsorption) symptoms; 4) to improve quality of life and prolong survival, and 5) to provide supportive and nonjudgmental care to establish a trusting relationship with the patient.

For patients with symptoms, the goal is nutritional support and diet must be individualized. Sometimes neutropenic diet is used (because of a weakened immune system) to help protect patients from bacteria and other harmful organisms found in food and drinks. A neutropenic diet involves cooking foods (like beef, chicken, fish, and eggs) completely to make sure that all bacteria are destroyed. Hence, raw foods are avoided and extra caution during the preparation of food is done to protect against food-borne infection.

The following are the dietary management of common symptoms of HIV/AIDS:

Sore mouth and throat

• It is best to avoid citrus fruits, tomatoes and spicy foods including very sweet foods. It is recommended to eat thick, smooth foods such as pudding, porridge, mashed potato, mashed carrots or other non-acidic vegetables or fruits and then drink high-energy, high protein liquids with a straw.

Oral/ esophageal lesions

• Soft, semi-soft, or liquid diets are best for patients with oral lesions. Avoidance of foods that are very hot or very cold, acidic, and spicy. Hence, it is advised to maintain oral hygiene.

Nausea, vomiting and early satiety

• Eating small snacks like crackers, toast, and other plain dry foods throughout the day can help with nausea. It is better to drink diluted fruit juices, other liquids and soup while avoiding foods that have a strong aroma. It is also advised to avoid gas-forming foods, caffeine, and tobacco.

Thrush (Fungal (yeast) infection that can grow in your mouth, throat, and other parts of your body

• Eating soft, mashed foods that is either cold or at room temperature can alleviate the pain. Spicy, sugary, salty, sticky and acidic foods is best avoided since it could cause irritation of the mouth sores. Also, drink plenty of liquids excluding alcohol.

Dysgeusia or altered taste

•  Trying new foods with liberate use of herbs and spices can ease the bad taste they feel in the mouth. Serving food using plastic utensils to help avoid a “metallic taste”. Marinating meats and poultry using flavor enhancers such as salt, spices, herbs, and lemon can increase the taste and help stimulate receptors.

Anorexia, fatigue, and lethargy

• Give small frequent meals regardless of appetite, that is high in calorie and protein. Eat foods that don’t require preparation and refrain from drinking liquids between snacks or meals. Ask and consult a physician or a registered dietitian before taking modular supplements, protein, or glucose polymers to foods and liquids.

Loose bowels and severe diarrhea

• It is recommended to eat smaller meals comprised of foods rich in soluble fiber like bananas, millet, peas, and lentils. Dairy products and high-fat foods are best eliminated because they may aggravate the symptoms. Drinking an oral rehydration solution may help in alleviating severe diarrhea.

Infection and fever

• In case of fever and infection, it is best to eat in small portions of soft, preferred foods with a pleasing aroma and texture throughout the day. Whenever possible, offer high-calorie and high protein foods/fruit juices. Consult a doctor/registered nutritionist-dietitian before providing multivitamin/mineral supplements.

Knowing how vulnerable people with HIV are, it is harder for their bodies to fight off infections. This is the reason why good nutrition is a must for them. With the side effects of HIV medicines and all the nutrition-related symptoms it causes, good nutrition can greatly help in maintaining a healthy weight, absorbing HIV medicines, and keeping them healthy.

/SKP

REFERENCES:

MEDICAL NUTRITION THERAPY FOR FILIPINOS, 6^th edition, Adela Jamorabo-Ruiz, Virginia S. Claudio, and Esperanza E. de Castro

National Institute of Health. Living with HIV. Retrieved from https://hivinfo.nih.gov/understanding-hiv/fact-sheets/hiv-and-nutrition-and-food-safety