MNT and Medical Management/Treatment of HIV and Aids

Prevention

PREP and PEP for pre and post-exposure prophylaxis
Vaccines, microbicides, and antibodies being tested

What do you want to monitor?

CD4 Count and viral load

Antiretroviral therapy (ART)

Initiate asap
Six classes of drugs
Usually, a combo is prescribed
Lifelong treatment
Nonadherence leads to drug resistance

Food/drug interactions

Interactions with grapefruit juice
Timing important

Side Effects of Food/drug interactions

Anorexia
N/V
Diarrhea
Fatigue
Reflux
Dry Mouth
Altered sense of taste
Dyslipidemia
Insulin resistance
_____ Co infection with hepatitis C

Nutrition Assessment

Upon diagnosis
At least one MNT visit per year after initial assessment
HIV associated Lipodystrophy Syndrome (HALS)

HALS

Lipohypertrophy.
Lipoatrophy,
Circumference measurements, Associated with dyslipidemia and insulin resistance

Lipohypertrophy

abdomen, back of neck, breasts, under skin

Lipoatrophy

arms, legs, buttocks, face

Food Safety:

Avoid unpasteurized dairy products and juices
Avoid raw or undercooked eggs, meat, poultry, seafood

Energy

Depends on weight goals and medical factors
Needs increase 20-50% with opportunistic infection

Fat

Omega 3 fatty acid foods

What to recommend for druge related diarrhea

Probiotics, Prebiotics, and glutamine

Micronutrients for concern HIV/Aids

Vitamin B12
Vitamin A
Beta-carotene
Vitamin E
Vitamin D
Selenium
Zinc
Iron

Supplementation above DRI for HIV and Aids recommended or not recommended?

Not recommended

What is the best vitamin to give to patients

Multivitamin with minerals

MNT should begin for patients with HIV disease

At the time of diagnosis

Which of the following is not a predictor of poor adherence to antiretroviral therapy (ART)

Cause of HIV infection

Which of the following promotes GI health in HIV

Glutamine and probiotics

In patients with HIV disease. Loss of body weight is usually associated with increase in

Viral load

Viral load ____ as disease progresses

increases

As viral load increases, CD4 cell count

decreases