Description
Book SynopsisWritten by a specialist dietitian for dietitians and related health professionals Contributions from an international team of authors Covers paediatric and adult care Includes international case studies .
Trade Review“Students and other health care professionals working and studying this area will also find Nutrition and HIV an important and valuable resource.” (MedReview, 1 November 2012)
"This book delivers comprehensive, evidenced-based information on the nutritional management of HIV patients. Given the great detail, it would best serve as a resource for dietitians who regularly care for HIV patients." (Doody's, 19 August 2011)
Table of ContentsList 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
