Manifestation of HIV infection with nutritional

implications
Body Site Affected
Manifestation

Malignancies 50% of patients with KS lesions

Odynophagia, dysphagia,
Kaposis Sarcoma of the skin may have involvement
Abdominal pain, obstruction,
(KS) of the GI tract , including hard and
nausea vomiting, bleeding,
Soft palate, small intestine,
rarely diarrhea
Stomach and liver.
Non-hodgkins GI tract
Nausea,vomiting , dsyphagia,
Lymphoma and
hematemesis, lower GI tract,
Burketts lymphoma
bleeding obstruction,

Abdominal pain ,diarrhea

Fungi
Candida albicans Oral and esophageal involvement
Dsygeusia, dysphagia,
With dense plaques of exudate
decreased salvation, , burning,

Odynophagia,nausea,and upper

GI bleeding
Cryptococcus Meningitis
Fever, nausea, vomiting,
Neformans
dementia
Histoplasma Lung,bone marrow, liver, spleen,
fever,weight loss.dsyphagia
Capsulatum ulcerated lesions of oropharynx

Viruses
Herpes simplex virus lesions of oral cavity ,esophagus ,
Odynophagia, dysphagia,
(HSV) anorectal area
esphagitis, procitis , local
Pain ,constipation
Cytomegalovirus Identified in 90% of patients with
Esophagitis ,restrosternal pain,
(CMV) AIDS at autopsy, Ulcerative
gastritis, enteritis, colitis,
lesions may appear in entire GI
proctitis , watery or bloody
tract especially esophagus,
diarrhea , biliary disease,
stomach ,small intestine, colon,
perforations of affected organ.
Biliary tract,
Epstein-Barr virus Tongue
Oral hairy leukoplakia
(EBV)
Human immuno- Low-grade small bowel atrophy; May
contribute to diarrhea ,
Deficiency virus also found in gastric mucosa
malabsorption,gastritis,
Protozoa
Cryptosporidium spp entire GI tract, especially
Profuse, watery diarrhea ,
Microvilli of small intestine and
malabsorption, steatorrhea,
Biliary tract
lactose intolerance ,abdominal

Pain,cholecytitis,pancreatitis,

Nausea,vomiting,dehydration,

Low electrolytes ,malnutrition.

Isospora belli Microvilli of small intestine Often
indistinguishable from

Cryptosporidium spp.

Symptoms may includ3e

Diarrhea , steatorrhea,

Abdominal pain, anorexia ,

Vomiting ,fever.
Microsporidia Small intestine
Diarrhea, malabsorption
Giardia lambia Small intestine
Nausea, bloating , abdominal

Cramping, diarrhea , fever,

Malaise, weight looss. Increased

Flatus
Entamoeba histolytica Large intestine
Diarrhea, proctocolitis
Pneumocystis carinii Lungs,may be disseminated
Dyspnea, fever, coughing,
Pneumonia
weight loss
Toxoplasma gondii Encephalitis
Fever,dementia

Bacteria
Mycobacterium avium Intestine, liver , spleen, lymph
Fever,weight loss , cachexia,
Intracellulare (MAI) nodes , bone marrow
malaise, diarrhea,

Malabsorption, steatorrhea
Salmonellae Large intestine
Diarrhea , abdominal pain,

Fever, bacteremia, high

Propensity for recurrence i Shigellae Large

intestine Abdominal pain (cramping),

Tenesmus, fever, bloody

Diarrhea, bacteremia, high

Propensity for recurrence

Campylobacter jejuni Large and small intestine
Abdominal pain, fever, bloody

Diarrhea.

Oral manifestation
Periodontal disease, Gingival erythema resulting in Severe
mouth pain, tooth loss,
Gingivitis, spontaneous bleeding, rapid loss
halitosis
 Of periodomal attachment and
Bone

There is a pattern of wasting and malnutrition in AIDS patients which

consist of increased losses of lean body mass and variable lossesof fats. As as
result, the immune function of the individual is compromised.
Malnourished individuals may be more susceptible to infections and make it
more difficult to recover from infections.
Filipino AIDS cases typically suffer from many concurrent infections . at
the research institute for tropical medicine AIDS Center, the most frequently
reported infections encountered among Filipinos suffering from AIDS
Include the following : candida infections (thrush), tuberculosis, P. Carinii
phenumonia, cryptosporidial diarrhe
Cytomegalovirus infections ,urinary tract infections, V zoster infections, HIV
dementia, oral hairy leukoplakia, Salmonella sp. Bacteremia, C. Neoformans
infection, other forms of diarrhea dermatitis , A. Lumbricoides, bacterial
pneumonia , viral hepatitis , and kaposis sarcoma.

Nutrition-related side effects of commonly prescribed medications in

HIV infection and AIDS
Medication Condition treated
Nutrition Side Effects
Bactrim Preumocystic carinii >
Nausea
(trimethoprisulfamethoxasole) pneumonia (PCP) >Vomiting

>Glossitis/stomatitis

>Hyponatremia
Pentamidine Isethionate PCP
>Alternation in taste

>Hypoglycemia/Hyperglycemia

>Nausea

>Vomiting
>
Hypocalcemia
Dapsone With sulfamethoxazole
>Anorexia
For PCP
>Nausea

>Vomiting
Pyrimethamine With sulfadiazine for
>Megaloblastic anemia
Toxoplasmosis
>Vomiting

>Anorexia

>tongue tenderness
Acyclovir (Zovirax) Herpes simplex
>Occasional nausea
Herpes zoster
>Occasional vomiting
AZT (Zidovudine, retravir ) Inhibits HIV replications >Nausea

>Vomiting

>Taste alterations
DHPG Cytomegalovirus (CMV ) >Diarrhea
(rarely )

>Vomiting ( rarely)
>
Gastric ulceration and gastrointestinal

Perforation ( rarely )
Amphotericin-B Crytococcal infection >Anorexia
Histoplasmosis
>Vomiting
Candidiasis
>Hypokalemia

>Hypomagnesemia

>Metallic taste
Ketoconazole Candidiasis >Needs
acidic stomach for absorption
Histoplasmosis
Dronabinol (Marinol ) Anorexia >Feelings
of euphoria,
Nausea and vomiting >Mood
changes , confusion,

>Decreased cognitive performance

>Altered memory
Megestrol acetate anorexia >Weight
gain
(Megace)
>Nausea and Vomiting

>Hyperglycemia

>Thromboembolic phenomena

>Alopecia
>Fetal
harm in pregnant women

>Possible bradycardia with IV use