Medical Nutrition Therapy for an HIV Patient
Section 1
HIV is a viral infectious disease that is contracted by means of contact with an infected person either via genitalia fluids (sexually), use of unsterile injecting needles or blood transfusions. From the patient’s previous drug history, it is probable that they contracted the HIV virus through unsterile needles. The patient, Mr. W is exhibiting signs of a severely compromised immune system. Mr. W is also extremely malnourished and underweight with a BMI of 15.8. Evidence of herpes simplex lesions around the mouth along with findings of Pnemocystis carinii, depressed T cell levels and a positive HIV test result all indicate the progression of the condition to AIDS. This is the stage of the HIV disease where the patient’s immune system is severely compromised and is susceptible to various opportunistic infections. This progression usually occurs when the number of the patient’s “CD4 cells falls below 200 cells per cubic millimeter of blood (200 cells/mm3) (“Stages of HIV Infection”,2015).” A normal, healthy persons’ CD4 count is usually 500-1600, even an HIV patient whose disease is controlled with ARVs and diet can still be within this range.
Section 2
During the initial stage of the disease known as the Acute HIV infection stage a patient may probably present with flu like symptoms. These symptoms include night sweats, a fever, fatigue, muscle weakness, sore throat, swollen lymph nodes, and mouth ulcers (“Symptoms of HIV,” 2015). Other signs, however, only appear in the progression to AIDS stage. For example, Mr. W’s chronic herpes simplex that caused ulcerative lesions in his mouth, the presence of Pneumocystis carinii, and the wasting of muscle mass (cachexia) are all symptoms and complications of this third stage. Other complications in the final stage of AIDS includes Tuberculosis, Candidacies of the esophagus, Cytomegalovirus infections (retinitis, colitis, etc.), Salmonella bacteremia of recurrent non-typhoidal type, and HIV associated cancers including Non-Hodgkin’s Lymphoma and Kaposi’s Sarcoma (Dr. Chris, 2010).
These complications tend to compromise the patient’s nutritional status profoundly because it results in HIV-associated weight loss which results in “greater loss of lean body mass than of fat mass (Swaminathan S., 2008).” An additional disease such as tuberculosis in an HIV/AIDS patient further worsens the nutritional status of the patient, simply because the body is using even more energy to fight off the already existing infection and the newly acquired one. The patient may even be too weak and frail to consume enough nutrients to match this high energy demand.
Section 3
The goal of nutritional therapy for this patient is to increase energy intake and reduce loss of nutrition caused by immense diarrhea and vomiting. Another goal is to replace the fluids and electrolytes lost with infusion therapy. A poor nutritional status in an HIV patient increases chances for progression and mortality associated with the disease.
The energy requirements in patients with HIV usually increase by 10% in order to be able to maintain body weight and prevent wasting. Patients whose disease has progressed into AIDS and are in “periods …
