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AIDS and HIV infection

There is still no cure for AIDS (acquired immune deficiency syndrome), nor is there a special diet for people infected with HIV, the human immunodeficiency virus that causes the disease. But good nutrition can prevent or delay weight loss and other complications.

Asymptomatic HIV-infected individuals should follow the same dietary practices recommended for healthy people, but with added precautions. Because the HIV organism attacks the immune system, it makes a person more vulnerable to infections, including food poisoning from salmonella, shigella, campylobacter, and other bacteria. Such food-borne infections occur more frequently and are more severe in people with reduced immunity.

Keep up your food intake. AIDS is a wasting disease, and death is often due to starvation rather than to other HIV complications. A patient should eat as much as possible and, unless markedly obese, not worry about gaining weight. The extra weight can be critical in seeing a patient through a crisis when he can't eat.

Unfortunately, maintaining good nutrition is complicated by the ways in which AIDS affects the digestive system. It reduces absorption of nutrients, especially folate, riboflavin, thiamine, and vitamins B6 and B12; it often causes intractable diarrhea, which causes further nutritional loss; and it increases the risk of intestinal infections. Many AIDS patients also suffer appetite loss and bouts of nausea, either from the disease or from medications.

If rapid weight loss occurs, the patient may require artificial (hyperalimentation) feeding; this is generally administered through a gastric feeding tube inserted into the stomach or an intravenous line that pumps predigested nutrients into the bloodstream. Some AIDS specialists advise artificial feeding if nutrients are not being absorbed properly.

Food safety

Anyone who is HIV-positive, or a person who prepares food for an AIDS patient, must pay special attention to food safety. Wash hands before handling food, during its preparation and after. Keep hot foods hot and cold foods cold. Avoid contact between raw and cooked foods. Eggs should be boiled for at least 7 minutes; meat and fish should be well cooked, with an internal temperature of 165F to 212F (72C-100C). Raw shellfish, sushi, steak tartare, rare hamburgers, as well as homemade mayonnaise and ice cream made with raw eggs must be avoided. Commercial mayonnaise and hard ice cream are safe.

Wash fruits and vegetables well. They are not as likely to cause problems as animal products, but they should be washed thoroughly. Many doctors advise following the same precautions as when traveling abroad; eat only cooked vegetables, and eat fruits that are peeled, stewed, or canned. Some feel salads and raw fruits and vegetables are safe but may be difficult to digest.

Use of supplements

Nutritionists often recommend that HIV-positive people take a multiple vitamin and mineral pill to prevent nutrition deficiencies; however, supplements with more than 100 percent of the Recommended Dietary allowance (RDA) should be used only if prescribed by a doctor. Many patients self-treat with high-dose supplements, a course that can lead to serious problems. High doses of vitamin C, for example, can worsen diarrhea.

Avoid harmful dietary approaches. some self-help groups advocate taking high doses of zinc and selenium to bolster the immune system. there is no proof that supplements of these nutrients protect against AIDS-related infections; in fact, studies show that taking 200 mg to 300 mg of zinc a day for 6 weeks actually lowers immunity. Excessive selenium can also cause vomiting and diarrhea.

Another dangerous dietary approach entails following a macrobiotic regimen, especially one restricted to brown rice and a few vegetables. Such a diet can actually worsen AIDS, because it fails to provide adequate nutrition; additionally, the excessive fiber can exacerbate diarrhea.

Herbal medicine is a popular self-care approach, though there is no evidence for its efficacy. Caution is needed as some herbal preparations contain substances that can cause serious side effects or interact with medications. Check with a doctor before taking any herbal or other preparation or engaging in self-treatment or alternative medicine.


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