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Nutrition and HIV
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Main description:

Today over 40 million adults and children worldwide are infected with HIV, however knowledge of the disease has increased greatly and the prognosis is now good for those with access to anti–retroviral treatment.

For many, HIV is now a long–term chronic condition and with decreased mortality, patient requirements and disease patterns have changed, making it increasingly apparent to health care professionals that the treatment of HIV should include optimum nutrition and healthy lifestyle interventions to help sufferers lead long and healthy lives.


In this essential new book an international team of authors under the editorship of Specialist HIV Dietitian Vivian Pribram bring together the latest research to provide the practicing dietitian and nutritionist with a practical guide to the nutritional care of the HIV and AIDS patient. Students and other health care professionals working and studying this area will also find Nutrition and HIV an important and valuable resource.


Back cover:

Today over 40 million adults and children worldwide are infected with HIV, however knowledge of the disease has increased greatly and the prognosis is now good for those with access to anti–retroviral treatment.

For many, HIV is now a long–term chronic condition and with decreased mortality, patient requirements and disease patterns have changed, making it increasingly apparent to health care professionals that the treatment of HIV should include optimum nutrition and healthy lifestyle interventions to help sufferers lead long and healthy lives.


In this essential new book an international team of authors under the editorship of Specialist HIV Dietitian Vivian Pribram bring together the latest research to provide the practicing dietitian and nutritionist with a practical guide to the nutritional care of the HIV and AIDS patient. Students and other health care professionals working and studying this area will also find Nutrition and HIV an important and valuable resource.


Contents:

List of Contributors xiv


Preface xviii


Acknowledgements xix


SECTION 1: INTRODUCTION


1 Introduction to Human Immunodeficiency Virus 3
Tanya Welz, Amanda Samarawickrama, Vivian Pribram, Bavithra Nathan, Lisa Hamzah and Emily Cheserem


1.1 Introduction 3


1.2 Current state of the epidemic 4


1.3 HIV transmission 5


1.4 About the virus 6


1.5 Diagnosis of HIV 8


1.6 Measurement of CD4 cells 8


1.7 Natural history of untreated HIV infection and AIDS 10


1.8 Staging and classification of HIV disease 10


1.9 Monitoring the HIV pandemic 12


1.10 Prevention 13


1.11 Effect of antiretroviral therapy on the HIV epidemic 14


1.12 Stigma 14


2 Introduction to Nutrition and HIV 18
Vivian Pribram


2.1 Introduction 18


2.2 Malnutrition, infectious disease and immune function 19


2.3 HIV infection and decreased nutritional status 21


2.4 Nutritional screening and assessment 22


2.5 Metabolic and morphological complications 23


2.6 Paediatric undernutrition and maternal and child health 24


2.7 Healthy eating and management of HIV for well–being and longevity 26


2.8 Management of co–morbidities and serious non–HIV conditions 27


2.9 End–of–life care and ethical issues 29


SECTION 2: PAEDIATRIC NUTRITION, MATERNAL AND CHILD HEALTH


3 Malnutrition, Infant Feeding, Maternal and Child Health 35
Theresa Banda, Vivian Pribram, Margaret Lawson, Catherine Mkangama and Gertrude Nyirenda


3.1 Introduction 35


3.2 Maternal health and nutrition 36


3.3 Mother–to–child transmission 41


3.4 Infant feeding in the context of HIV 43


3.5 Malnutrition in children with HIV 49


4 Paediatric Nutritional Screening, Assessment and Support 58
Lisa Cooke


4.1 Introduction 58


4.2 Nutritional assessment and screening 58


4.3 Dietary assessment what to do 61


4.4 Nutritional support 68


5 Adherence, Symptom Management, Psychological Aspects and Multidisciplinary Care of Children with HIV 72
Daya Nayagam, Paul Archer, Susheela Sababady, Shema Doshi, and Ella Sherlock


5.1 Transmission of HIV in children and young people 72


5.2 Prevention of mother–to–child transmission (vertical transmission) 73


5.3 Clinical presentation of paediatric HIV infection 73


5.4 Failure to thrive 73


5.5 Central nervous system 74


5.6 Hepatosplenomegaly 74


5.7 Older children 74


5.8 HIV disease and opportunistic infections 74


5.9 Prophylaxis 74


5.10 Antiretroviral treatment for children 75


5.11 Monitoring of paediatric HIV infection 77


5.12 Caring for children and their families in the community 77


5.13 Adherence, symptom management, psychological aspects and multidisciplinary care of children with HIV and AIDS 78


5.14 Nutritional care in a multidisciplinary team setting 81


5.15 The psychological effects of HIV on family functioning key themes which arise in a child setting 82


6 Healthy Eating, Prevention and Management of Obesity and Long–Term Complications in Children 87
Julie Lanigan


6.1 Introduction 87


6.2 Metabolic complications 88


6.3 Malnutrition and HIV 88


6.4 Micronutrients and HIV 88


6.5 Obesity 90


6.6 Lipodystrophy 91


6.7 Assessment and monitoring 94


6.8 Dietary intake assessment 94


6.9 Advice for healthy eating 94


6.10 Conclusion 100


SECTION 3: NUTRITIONAL MANAGEMENT OF HIV DISEASE


7 Decreased Nutritional Status and Nutritional Interventions for People Living with HIV 107
Vivian Pribram


7.1 Introduction/Background 107


7.2 Malnutrition, weight loss and wasting 107


7.3 Significance of involuntary weight loss 108


7.4 Definitions of HIV–related weight loss and wasting 109


7.5 Prevalence 110


7.6 Aetiology 110


7.7 Nutritional requirements 116


7.8 Nutritional management 117


7.9 Non–nutritional treatments for HIV–related muscle wasting 122


7.10 Micronutrients 125


7.11 Conclusions 128


8 Nutritional Screening and Assessment 132
Sarah Woodman, Michelle Sutcliffe and Amy McDonald


8.1 Overview 132


8.2 Nutritional screening in the clinical setting 134


8.3 Nutritional assessment 136


8.4 Biochemical assessment 146


8.5 Clinical assessment 148


8.6 Dietary and lifestyle assessment 150


8.7 Conclusion 153


9 Symptom Control and Management 157
Louise Houtzager and Tim Barnes


9.1 Symptoms experienced by people living with HIV 157


9.2 Referring patients to a dietitian for symptom control and management 158


9.3 Goals of dietary symptom management strategies 159


9.4 Symptom control and management of diarrhoea 159


9.5 Symptom control and management of loss of appetite 165


9.6 Mouth pain, taste changes and swallowing difficulties 165


9.7 Reflux (heartburn) 170


9.8 Symptom control and management of nausea and vomiting 171


9.9 Symptom control and management of fatigue 171


9.10 Conclusion 174


10 The Nutritional Management of Complications Associated with HIV and Antiretroviral Therapy 176
Alastair Duncan and Karen Klassen


10.1 Introduction 176


10.2 Aetiology of metabolic side effects 177


10.3 Prevalence of metabolic side effects 178


10.4 Assessment of metabolic parameters and cardiovascular disease risk 179


10.5 Management of dyslipidaemias 180


10.6 Management of impaired glucose metabolism 185


10.7 Management of altered fat distribution 188


10.8 Altered bone metabolism 193


10.9 Management of lactic acidaemia 199


10.10 Peripheral neuropathy 199


10.11 Routine assessment, dietary and lifestyle management of metabolic complications 200


10.12 Summary 201


11 Community Interventions in Resource–Limited Settings 212
Claire de Menezes and Kate Ogden


11.1 Introduction 212


11.2 HIV and nutrition in resource–limited settings 213


11.3 Assessment of needs and capacities 215


11.4 Targeting 217


11.5 Nutrition counselling and education 218


11.6 Targeted food supplementation programmes 221


11.7 Support of HIV–positive pregnant women 223


11.8 Breastfeeding and infant feeding support 225


11.9 Support for other vulnerable groups 227


11.10 Treatment of severe acute malnutrition in HIV context 229


11.11 Micronutrient supplementation programmes 230


11.12 Livelihood support and ensuring access to food 230


11.13 Community mobilisation to support people living with HIV 234


11.14 Monitoring 236


11.15 Other issues 237


11.16 Conclusion 238


SECTION 4: HEALTHY LIVING AND LONG–TERM MANAGEMENT


12 Medications, Adherence and Interactions with Food 243
Angela Bailey


12.1 HIV medications background 243


12.2 Drug interactions 256


12.3 Micronutrients used in HIV infection 257


12.4 Food and drug interactions 257


12.5 Adherence 261


12.6 Adherence and food 264


12.7 Looking to the future 266


12.8 Conclusion 268


13 Healthy Eating and Well–Being 275
Vivian Pribram and Kirsten Foster


13.1 Diet, lifestyle and disease prevention 275


13.2 The importance of healthy eating for people living with HIV (PLHIV) 276


13.3 Factors that affect healthy eating and improved well–being among PLHIV 277


13.4 Other lifestyle factors that influence health outcomes 280


13.5 Principles of healthy eating 282


13.6 Portion sizes and quantity of food required 295


13.7 Weight management for people living with HIV 295


13.8 Summary 299


14 Exercise and Physical Activity and Long–Term Management of HIV 302
Joanna Lucy Bowtell and Rebecca Weissbort


14.1 Introduction 302


14.2 Observational studies 304


14.3 Effect of exercise on immunological parameters 305


14.4 Effect of exercise on wasting 306


14.5 Management of metabolic disturbances with exercise programmes 308


14.6 Effect of exercise on quality of life and physical capacity 312


14.7 Exercise prescription for people living with HIV/AIDS 313


14.8 Practical considerations for exercise prescription 314


14.9 Exercise programme for a patient living with HIV 316


14.10 Conclusion 319


15 Mental Health 324
Shirley Hamilton and Christian Lee


15.1 Introduction 324


15.2 Mental disorders and nutrition 324


15.3 Acute cognitive impairment 325


15.4 Delirium and nutrition 326


15.5 Chronic cognitive impairment 326


15.6 Chronic cognitive impairment and nutrition 327


15.7 Depression 327


15.8 Depression and nutrition 328


15.9 Management of depression 329


15.10 Suicide 332


15.11 Management of suicidal ideation 333


15.12 Mania 333


15.13 Mania and nutrition 333


15.14 Anxiety 334


15.15 Psychosis 336


15.16 Socio–economic factors for mental health/HIV clients affecting nutrition 339


15.17 Personality disorders 340


15.18 Dual diagnosis 340


15.19 Nutritional management of patients with HIV/mental health issues 341


16 Complementary and Alternative Therapy 345
Charle Maritz, Sharon Byrne and Vivian Pribram


16.1 Introduction 345


16.2 Safety and regulation of CAT therapy 346


16.3 Use of CAT 346


16.4 Factors influencing use of CAT 347


16.5 CAT use in HIV 347


16.6 Reasons for CAT use among PLHIV 348


16.7 Information sources about CAT 349


16.8 Disclosure of CAT use 349


16.9 Evidence for the use of CAT 349


16.10 Dietary supplements 350


16.11 Dietary supplement use among PLHIV 350


16.12 Knowledge of drug CAT interactions 351


16.13 Herbal remedies 353


16.14 Addressing patients use of CAT 356


16.15 Conclusions 356


17 Food and Water Safety 360
Louise Houtzager


17.1 Introduction 360


17.2 Why food and water safety is important for PLHIV 360


17.3 Causes of food– and waterborne illness in PLHIV 362


17.4 Management and prevention of food–borne illness 373


17.5 Conclusion 380


SECTION 5: THE NUTRITIONAL MANAGEMENT OF HIV AND CO–MORBIDITIES


18 The Nutritional Management of Patients Living with Tuberculosis and HIV Co–Infection 385
Louise Houtzager, Tim Barnes and Kirilee Matters


18.1 Tuberculosis 385


18.2 Epidemiology 386


18.3 The relationship between tuberculosis and HIV 387


18.4 Medical issues 388


18.5 Nutrition, HIV infection and TB 390


18.6 Nutrition screening 392


18.7 Nutrition assessment: special considerations in TB 392


18.8 Nutritional treatment/intervention 393


18.9 Recommendations 394


19 The Nutritional Management of Patients Living with HIV and Renal Disease 396
Deepa Kariyawasam


19.1 Introduction 396


19.2 Presentation and symptoms 397


19.3 Screening 397


19.4 Diagnosis 397


19.5 Classification of chronic kidney disease 397


19.6 Treatment 398


19.7 Methods of renal replacement therapy 398


19.8 Renal transplantation 399


19.9 Nutritional issues on dialysis 402


19.10 Nutritional assessment 402


19.11 Nutritional requirements 403


19.12 Treatment 403


19.13 Conclusion 409


20 The Nutritional Management of Patients Living with HIV and Liver Disease 412
Tracy Russell and Ruth Westwood


20.1 Introduction 412


20.2 Hepatitis B, hepatitis C and HIV 413


20.3 Nutrition and liver disease 415


20.4 Liver transplantation 420


20.5 Nutritional interventions for hepatitis C 420


20.6 HIV and non–alcoholic fatty liver disease 421


20.7 Use of complementary and alternative therapies (CAT) in liver disease 422


20.8 Vulnerable groups 423


20.9 Conclusion 424


21 Critical Care, Respiratory and Multi–organ Failure 427
Sarah Cassimjee


21.1 Background/overview 427


21.2 Diseases and infections associated with ITU admission 428


21.3 Sepsis and multiple organ dysfunction syndrome (MODS) 430


21.4 Neurological failure 430


21.5 Cardiovascular failure 430


21.6 Gastrointestinal (GI) failure 430


21.7 Liver failure 430


21.8 Renal failure 431


21.9 Medical treatment 431


21.10 Nutritional considerations 431


21.11 Nutritional assessment 433


21.12 Nutritional requirements 433


21.13 Nutritional treatments/intervention 438


21.14 Early feeding and the use of enteral feeding protocols 438


21.15 Conclusion 439


22 Nutritional Management of Patients Living with HIV and Cancer 442
Rachael Donnelly and Rachel Barrett


22.1 Introduction 442


22.2 Science of cancer 443


22.3 Overview of cancer treatments 444


22.4 Cancers in HIV infection 447


22.5 Nutrition in the management of non–surgical oncology patients 451


SECTION 6: PALLIATIVE, END OF LIFE CARE AND NUTRITION


23 Nutrition and End of Life Care 459
Vivian Pribram


23.1 Introduction 459


23.2 Palliative care 461


23.3 Nutritional care in later stages of progressive illness 462


23.4 Ethical and legal considerations 464


23.5 Withdrawal of nutrition 469


23.6 Implications for practice 470


23.7 Conclusion 470


APPENDICES 473


Appendix 1 WHO Clinical Staging of HIV/AIDS for Adults and Adolescents 475


Appendix 2 Weight–for–Height Reference Card (87 cm and above) 477


Appendix 3 Weight–for–Length Reference Card (below 87 cm) 478


Appendix 4 Guidance Table to Identify Target Weight 479


Appendix 5 Basic Steps in Estimating Energy Requirements for Adults 480


Appendix 6 NICE Guidelines: What to Give in Hospital and the Community 482


Appendix 7 Basic Steps in Estimation of Nitrogen Requirements for Adults (Source: Elia, 1990) 484


Appendix 8 Summary of ESPEN Statements: HIV and Nutritional Therapy 485


Appendix 9 Form for Monitoring Anthropometry Measurements 487


Appendix 10 Equations to Calculate Height and Estimation of Height from Ulna Length 488


Appendix 11 Mid Upper Arm Circumference (MUAC) 490


Appendix 12 Mid Arm Muscle Circumference (MAMC) 491


Appendix 13 Biochemical Reference Ranges 492


Appendix 14 Ways to Improve Adherence to TB Medication 493


Appendix 15 The BCG Vaccination 494


Index 495


PRODUCT DETAILS

ISBN-13: 9781405182706
Publisher: John Wiley & Sons Ltd (Wiley–Blackwell)
Publication date: October, 2010
Pages: 528
Dimensions: 175.00 x 243.00 x 27.95
Weight: 916g
Availability: Available
Subcategories: Diseases and Disorders, General Practice, Infectious Diseases, Nutrition

MEET THE AUTHOR

Vivian Pribram, Specialist Dietitian, King s College Hospital, London, UK

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