Some symptoms will require additional attention beyond general nutritional recommendations. For example, diarrhea will rapidly reduce the water content of the body, causing severe alterations in the body's metabolism and electrolyte balance. Electrolytes may be replaced with products such as Pedialyte or Gatorade. Proteins and calories should be increased to prevent weight loss, and dairy products, alcohol, caffeine, and spicy and fatty foods should be avoided.
A second complication is that of weight loss and wasting. According to Derek Macallan, in Wasting HIV Infection and AIDS, wasting may be either acute (associated with a secondary disease) or chronic (associated with gastrointestinal disease), and is the result of a variety of processes, including drug use, medications, concurrent disease, and HIV itself. HIV infection causes abnormal protein and fat metabolism. During episodes of acute wasting the patient may require a prescription for steroids, to help support tissue maintenance and tissue development, in combination with optimal protein and calories in the diet.
Contributing to weight loss and wasting is malabsorption (the failure of nutritional substances to be absorbed in the intestines). Malabsorption occurs in advanced cases of HIV infection when gastrointestinal disease is present. Diseases that can cause malabsorption in HIV/AIDS patients include Kaposi's sarcoma, non-Hodgkin's lymphoma, cytomegalovirus, Mycobacterium avium complex, and cryptosporidiosis. Malabsorption may require an alternative to oral nutrition.
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