Special Eating Needs For People Living With Hiv/aids
A person who is infected with HIV/AIDS and is not showing signs of illness does not need a specific HIV-diet. However, those infected with HIV should make every effort to adopt healthy and balanced nutrition patterns in order to meet their increased protein and energy requirements and maintain their nutritional status.
Once people with HIV/AIDS become ill they will have special needs, which are described below.
Hiv/aids Reduces Food Intake
People with HIV/AIDS often do not eat enough because:
- the illness and the medicines taken for it may reduce the appetite, modify the taste of food and prevent the body from absorbing it
- symptoms such as a sore mouth, nausea and vomiting make it difficult to eat
- tiredness, isolation and depression reduce the appetite and the willingness to make an effort to prepare food and eat regularly
- there is not enough money to buy food.
What Is Telogen Effluvium
Telogen refers to hair that isnt growing because its in the resting state. Effluvium is a scientific word that means outflow, or the shedding of hair. Telogen effluvium occurs when too many hairs stop growing for too long of a period. When new hair finally begins to grow, it pushes the resting hairs out, resulting in shedding.
Very little is known about TE, but people with HIV can be prone to the condition.
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Wasting And Weight Loss
Severe and unexplained weight loss is a serious symptom of advanced HIV infection. Wasting also called cachexia is now rare becasue of the effectiveness of HIV treatment .
Severe weight loss is defined as an unexplained loss of more than 10% over 12 months. It is usually caused by difficulties absorbing food .
Severe weight loss or wasting is life threatening. It usually reverses after starting ART.
If someone with diarrhoea has weight loss, the cause of the diarrhoea needs to be found. As well as treating the cause, you need to look at diet changes to reduce diarrhoea and improve nutrition. The same is true for nausea and vomiting. Anti-nausea and anti-sickness medication should be prescribed.
Often the best long term response is ARV treatment. But even people using ARV treatment can have difficulty regaining and maintaining higher weight.
Losing Weight When You Are Hiv
HIV positive people who need to lose weight should follow the same general weight loss recommendations as the rest of the population. You should always eat a balanced meal that does not exceed your caloric needs. You need to exercise and avoid junk food.
Sure, we know all of these things, but how do we actually start?
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Acute Hiv & Weight Loss
Acute HIV refers to the 6-to-12-week period when HIV infection first occurs. It is during this time that HIV antibodies develop, creating the virus that attacks the immune system. Over time and without treatment, HIV can lead to AIDS. Although weight loss does not occur during the acute HIV infection stage, it is present throughout the rest of the disease life cycle. Without careful medical management, and sometimes even with it, the extreme weight loss associated with the disease can be fatal.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
Darunavir Has A High Barrier To Drug Resistance
SYMTUZA® contains darunavir, which can help you keep fighting HIV with its high barrier to HIV drug resistance. Darunavir can help stop HIV from replicating. This is why treatments containing darunavir are recommended by the Department of Health and Human Services Guidelines when treatment is started immediately after an HIV diagnosis.
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Rise In Lipid Levels With Taf
There are a number of studies showing that TDF-containing regimens oftentimes improve lipid levels by decreasing total cholesterol, LDL cholesterol and triglycerides, while TAF-containing regimens increase these levels. Higher levels of total cholesterol and LDL cholesterol can promote plaque buildup in arteries, which can lead to coronary artery disease, stroke and other health problems.
In the DISCOVER study, which compared Descovy to Truvada for PrEP, triglyceride and LDL cholesterol levels increased at 48 weeks for people taking Descovy compared to no change or a decrease in people taking Truvada. Decreases were seen in total cholesterol and HDL cholesterol .
Other studies have compared the lipid levels of people living with HIV taking TAF-containing or TDF-containing treatment regimens or switching from a TDF-containing regimen to a TAF-containing regimen.
Anobservational study conducted in Spain compared the lipid profiles of people on Genvoya or Stribild for HIV treatment over 48 weeks.
Lipid levels increased from baseline among people taking Genvoya while remaining stable among people taking Stribild after 48 weeks of treatment. A higher percentage of people taking Stribild also had total cholesterol levels and LDL levels out of range after 48 weeks of treatment. Six people in the study discontinued Genvoya due to changes in lipid levels, and lipid levels returned to normal levels after returning to treatment that included TDF.
Drug Therapy For Wasting Syndrome
Table 4 summarizes the different types of drugs used in the treatment of HIV-related wasting syndrome. The use of appetite stimulants and antiemetics in conjunction with caloric supplementation has long been considered a mainstay of therapy. In planning the treatment approach, it is important to differentiate between nausea and anorexia. In addition, underlying causes of gastrointestinal symptoms, such as drug toxicity, should be sought and resolved whenever possible.
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To Add Calories To Your Diet
The best way to increase calories is to add extra fat and carbohydrates to your meals.
Fats are more concentrated sources of calories. Add moderate amounts of the following to your meals:
- butter, sour cream, cream cheese, peanut butter
- sour cream, cream cheese, grated cheese
- avocados, olives, salad dressing
Evaluation And Treatment Of Weight Loss In Adults With Hiv Disease
BRUCE WILLIAMS, M.D., M.P.H., DEBRA WATERS, PH.D., and KATHERINE PARKER, M.S., R.D., University of New Mexico School of Medicine, Albuquerque, New Mexico
Am Fam Physician. 1999 Sep 1 60:843-854.
Weight loss late in the course of human immunodeficiency virus disease is common and often multifactorial. Increased energy expenditure in response to opportunistic disease, as well as to HIV infection itself, can lead to proteincalorie malnutrition similar to that observed in starvation. Weight loss of as little as 5 percent in patients with HIV infection is associated with an increased risk of disease progression. Loss of body cell mass carries a particularly poor prognosis, and aggressive measures should be taken to stop such depletion. Patients exhibiting unexpected weight loss should be carefully examined to exclude decreased food intake, malabsorption, occult infection or neoplasm as the etiology of the weight loss. Early aggressive treatment of HIV disease and underlying opportunistic pathology, along with adequate pharmacologic, hormonal, nutritional and physical therapy, can often restore normal weight and body composition.
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Nutrient Deficiencies And Low Calorie Intake
HIV weight loss may be due to nutritional deficiencies or not taking in enough calories, which can happen as a result of:
- neurologic disease, which may affect food intake or perception of hunger
- food insecurity due to psychosocial or financial issues
- malabsorption of nutrients due to nausea or diarrhea
- problems with the mouth or OIs making it more difficult to chew or swallow
- gastrointestinal issues, which may affect the absorption of nutrients or make people feel full more quickly
Why Is Weight Gain A Problem
If you were underweight when you started treatment, putting on a few pounds isnt a bad thing. Getting to a healthy weight gives your body strength to fight HIV and other infections. Doctors used to call this weight gain a return to health.
But now the scales have tipped in the other direction. People with HIV in the United States are more likely to be overweight than those who dont have the virus. Putting on too many pounds can lead to health problems like diabetes and heart disease. If you have HIV, youre already at higher risk for these conditions.
Weight gain is an important thing to consider when you and your doctor choose an HIV drug, especially if you were overweight to start. You may be able to switch to a medicine thats less likely to cause weight gain. Diet and exercise can help you stay at a healthy weight and avoid complications that are linked to being overweight.
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Who Guidelines For Nutritional Assesment In Adults With Hiv
With regard to nutrition assessment:
Measure weight, weight change, height, BMI, and mid upper-arm circumference .
Assess appetite, difficulty swallowing, nausea, diarrhea, and drug-food interaction effects.
Assess household food security.
With regard to malnutrition:
Mild to moderately malnourished adults , regardless of HIV status, should receive supplementary feeding. Usually, fortified blended foods, such as corn-soya blend , are provided, but compressed bars or biscuits and lipid-based nutrient supplements may also be used.
Severely malnourished adults should receive a therapeutic food, nutritionally equivalent to F100.
For initial treatment of severely malnourished adults aged 19 to 75 years, energy intake should be 40 kcal/kg/day for initial treatment of those aged 15-18 years, energy intake should be 50 kcal/kg/day.
With regard to dietary intake:
Energy intake in asymptomatic HIV infection should be increased by 10%.
During infection, the aim should be to reach the maximum achievable intake of 20-30% above normal intake during the recovery phase, intake should be increased to the maximum extent possible.
Multivitamin supplements should be started.
Working With A Nutritionist Helps
Whether you need to gain or lose weight, it’s helpful to work with a nutritionist to plan a diet that provides the number of calories and nutrients you need every day. In addition, try to exercise as much as possible, as this will help build and strengthen your muscles.
If you need to gain weight, you may be more comfortable eating six small meals throughout the day rather than three larger meals. Adding supplements, like Ensure, is one way to add concentrated calories and protein to your meal plan.
If you need to lose weight, a healthy dietone that is low in fat and high in whole grains, fruits and vegetables, plus lean protein and seafoodis a great approach that will also reduce your risk of heart disease and diabetes.
And if you are already at a healthy weight, researchers have found that a low-cholesterol diet could help you avoid the caused by some antiretroviral drugs.
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Dont Diet Simply Watch What You Eat
Like anyone with a weight problem, adjusting what and how much you eat is the first step to weight loss. An all-too-common problem is that we try fad diets and quick loss diets that may work in the short term but do nothing to keep the weight off. An effective diet is simply one that teaches you healthy eating habits that can serve you a lifetime.
Equally important is the need to identify exactly why you eat. Ultimately people eat for many reasons besides just hunger. Its important to think about what triggers your eating outside of mealtimes. With the help of your food diary, you can start figuring out when and why you are eating in order to identify and control those impulses.
Can Dovato Be Used For Prep
No, the Food and Drug Administration hasnt approved Dovato to be used as PrEP. This stands for pre-exposure prophylaxis. PrEP is the use of a drug to prevent someone at high risk for HIV from contracting it. People considered to be high risk include those who share needles or have sex without a condom or other barrier method.
At this time, only two medications are FDA-approved as PrEP:
- emtricitabine/tenofovir disoproxil fumarate
- emtricitabine/tenofovir alafenamide
If you think PrEP might be helpful to you, talk with your doctor about which medication might be best.
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Hiv Wasting And Antiretroviral Therapy
Before the advent of combination antiretroviral therapy , the prevalence of wasting was estimated to be as high as 37%. Yet, despite the effectiveness of ART, wasting still remains a significant concern, with some studies suggesting that anywhere from 20% to 34% of patients will experience some degree of wasting, albeit not at the catastrophic levels previously seen.
While ART is known to improve weight loss and malnutrition in people living with HIV, it may not necessarily prevent the loss of muscle mass or replace it once body weight is restored. More concerning still is the fact that the loss of as little as 3% of muscle mass can increase the risk of death in patients with HIV, while the loss of more than 10% is associated with a four- to six-fold greater risk.
A Sexually Transmitted Infection
Katie Salerno/Flickr Creative Commons
Contracting other sexually transmitted diseases can significantly increase the risk of getting HIV. For instance, some STDs like syphilis and herpes cause skin lesions that make it easier for HIV to enter the body.
STDs may also cause inflammation, which is something that is triggered by the body’s immune system. HIV preferentially infects defensive white blood cells, so when there are more of them around, it’s easier to contract HIV.
Having an STD like gonorrhea or syphilis means that you’ve engaged in unprotected sex, a key risk factor for HIV. So if you have been diagnosed with an STD, talk to your healthcare provider about how you can reduce your HIV risk.
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Hiv Symptoms Every Woman Needs To Know
Human immunodeficiency virus, or HIV, attacks the bodys infection-fighting immune system. Without treatment, HIV can lead to AIDS . At the start of the AIDS epidemic in the 1980s, people who were infected with HIV quickly progressed to serious disease. But todays treatments help lower the amount of virus in the bloodso people who are HIV-positive can live healthier, longer lives and not necessarily progress to AIDS.
More than one million people in the US live with HIV, and scarily, one in seven of them dont know they have it. HIV symptoms can be hard to detect. Within a month or two of HIV entering the body, 40% to 90% of people experience flu-like symptoms known as acute retroviral syndrome . But sometimes HIV symptoms don’t appear for yearsor even a decadeafter infection.
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“In the early stages of HIV infection, the most common symptoms are none,” Michael Horberg, MD, director of HIV/AIDS for Kaiser Permanente, in Oakland, California, tells Health. As many as one in five people in the United States with HIV doesn’t know they have it, according to the Centers for Disease Control . That’s why it’s so important to get tested, especially if you currently have or have had unprotected sex with more than one partner or use intravenous drugs.
HIV symptoms for women and for men are often the same here are 16 of the most common signs.
How Do I Keep From Losing Weight
Diet and Nutrition
Weight loss can be a common problem for people with relatively advanced stages of HIV infection, and it should be taken very seriously. It usually improves with effective antiretroviral therapy . Losing weight can be dangerous because it makes it harder for your body to fight infections and to get well after you’re sick.
People with advanced HIV often do not eat enough because:
- HIV may reduce your appetite, make food taste bad, and prevent the body from absorbing food in the right way. Some HIV medicines may also cause these symptoms .
- symptoms like a sore mouth, nausea, and vomiting make it difficult to eat
- fatigue from HIV or medicines may make it hard to prepare food and eat regularly
To keep your weight up, you will need to take in more protein and calories. What follows are ways to do that.
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Living Longer Means Aging Naturally
Today, many people with HIV live long lives. A recent study of HIV-positive adults in Canada and the United States showed that people diagnosed with HIV at the age of 20 may live as long as any other person in these countries.
This means that hormonal symptoms including male and female baldness can occur as part of the aging process. Many men are losing hair by the age of 60.
Issues related to the disease itself may be a compounding factor, although little research exists on the topic.
Iron deficiencies can lead to hair loss in premenopausal women. Anyone losing a large amount of blood regularly can develop an iron deficiency and consequently experience hair loss.
A thyroid gland that produces an excess or deficiency of hormones can also contribute to hair shedding.
People Living With Hiv/aids Have Increased Nutrient Needs
When infected with the HIV virus the body’s defence system – the immune system – works harder to fight infection. This increases energy and nutrient requirements. Further infection and fever also increase the body’s demand for food. Once people are infected with HIV they have to eat more to meet these extra energy and nutrient needs. Such needs will increase even further as the HIV/AIDS symptoms develop.
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Basic Steps Towards Weight Loss
If you are overweight or obese there are some basic steps that you can follow to lose weight. These steps are the same for everyone, regardless of age or HIV status.
A risky combination of drugs, when drug A interferes with the functioning of drug B. Blood levels of the drug may be lowered or raised, potentially interfering with effectiveness or making side-effects worse. Also known as a drug-drug interaction.
To get started, it will help you to know how much you are eating and how physically active you are in an average week. Keep a food and activity diary for a week.
You can download apps that can help track activity. Most smart phones come with activity monitors pre-loaded. Alternatively, you can wear an inexpensive pedometer to record how far you walk each day.
Get a weight loss plan. You can download a 12-week weight loss guide from the NHS website. The plan is designed to help you lose weight at a safe rate of 0.5kg to 1kg each week by sticking to a daily calorie allowance.
Limit your calorie intake. For most taller people, this means sticking to a calorie limit of no more than 1900kcal a day, and 1400kcal for most shorter people. As we are all different, ideally see your HIV dietitian to have your own target calculated. A very low calorie diet should only be attempted after consultation with an HIV dietitian.Remember that some antiretroviral drugs need to be taken with food. Check which drugs need to be taken with food here.