SEE: under complex; AIDS.
Malnutrition in the HIV-infected patient, including both starvation (weight loss from lack of food) and cachexia (loss of lean body mass). SEE: cachexia; cytokine; starvation.
PATHOPHYSIOLOGY: The mechanisms by which HIV causes malnutrition include decreased nutritional intake, metabolic abnormalities, and the combination of diarrhea and malabsorption. Decreased oral intake may be related to loss of appetite, oral or esophageal ulcers (esp. from Candida or herpes simplex virus), difficulty chewing, fatigue, changes in mental status, or inadequate finances. Metabolic abnormalities include elevated serum cortisol, decreased anabolism, micronutrient deficiencies (vitamin B12, pyridoxine, vitamin A, zinc, and selenium), and decreased antioxidants. Malabsorption and diarrhea affect 60% to 100% of patients with AIDS. Primary gastrointestinal pathogens that contribute to malnutrition include Cryptosporidia, Microsporidia, and Mycobacterium avium intracellulare. Concerns about diarrhea and fecal incontinence may underlie a patient’s decreased oral intake.
PATIENT CARE: Assessment and education of patients must begin as soon as they are diagnosed as having HIV infection. Obtaining a careful history of the patient’s normal nutritional intake and activity level provides the baseline for nutritional instruction. Patients are encouraged to maintain the recommended daily allowance (RDA) for all foods by following MyPyramid; protein intake of 1 to 2 g/kg of ideal body weight and vitamin and mineral intake three to four times the RDA are also encouraged. Small frequent feedings, good oral hygiene, limited fluids with meals, and the use of preferred foods are helpful strategies in countering anorexia. A written schedule may help the patient adhere to the recommended plan for intake. Any increase in exercise or activity must be accompanied by an increase in food intake.
artificial insemination by husband (homologous insemination).
American Industrial Hygiene Association; autoimmune hemolytic anemia.
Airborne infection isolation room, a room used for patients with respiratory pathogens. The room typically has negative air pressure, i.e., its ventilation system draws or sucks air out of the environment.
(al′mĕnt) A complaint, disease, or physical disorder, esp. a mild or chronic one.
(ī-loor″ŏ-fō′bē-ă) [Gr. ailouros, cat + -phobia] A phobia of cats.
Abnormal Involuntary Movement Scale test.
(ān′hŭm) [East African, to saw] Spontaneous loss of fingers or toes, typically occurring in Africa, due to the formation of a fissured, constricting band forming around the digit. SYN: spontaneous dactylolysis.