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HIV/AIDS
HIV/AIDS
Epidemiology : Indonesia
The majority of HIV infections are
transmitted sexually;
Injecting drug use is the second
most common mode of HIV
transmission
HIV/AIDS
HIV/AIDS
HIV/AIDS
HIV/AIDS
HIV/AIDS
HIV/AIDS
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Transmission
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Essential Nutrients
Poor nutrition
Weight loss, muscle
wasting, macro or
micronutrient
deficiency
Increased
nutrition
needs
because of
malabsorption,
decreased food
intake, infections,
and viral replication
HIV
Impaired
immune
system
Poor ability to
fight HIV and
other infections
Increased
vulnerability to
infection and
increased frequency
and duration of
opportunistic infections
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Essential Good
Nutrients
nutrition
Weight regained or
maintained, no
macro or
micronutrient
deficiency
Nutritional
needs met
Additional energy
needs met,
adequate diet,
dietary
management of
symptoms
Nutrition
interventio
ns
Stronger
immune
system
Improved ability
to fight HIV and
other infections
Reduced
vulnerability to
infection and
reduced frequency and
duration of
opportunistic infections
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illness or death
Mental health factors: depression
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Effect of HIV/AIDS on
Nutrition:
Reduced Absorption
absorption of food/nutrients
Caused by HIV infection, OIs and ART
Mediated by diarrhea and damage to
intestinal cells
Results in poor absorption of fats
Reduces absorption of fat-soluble
vitamins, such as vitamins A and E
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Etiology is multifactorial
Any weight loss of > 5% is associated with
AIDS-Associated Wasting
Syndrome
Associated with
Metabolic changes
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Malnutrition and
HIV/AIDS
Low BMI is associated with disease
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Malnutrition and
HIV/AIDS
Affect the body in similar ways
Affect the ability of the immune system
hypersensitivity
Alters CD4 / CD8 ratio
Impairs antibody response
Impairs bacteria killing
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microglia)
CD4+ Dendritic cells (inclu. Langerhans cells)
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Early Stage
No symptoms, stable weight
Increased nutritional requirements during HIV-
infection
also increased
Early Stage
Safe food and water handling practices
Wash hands before preparing and eating food,
Early Stage
Safe food and water handling
practices continued
Serve food immediately after preparation
Keep food covered and away from
Middle Stage
Significant, unintentional or undesirable
depressed appetite
Increase nutrition intake gradually to promote
weight and muscle mass gain, and nutritional
recovery
Make every bite count
Daily vitamin-mineral supplements
Continue physical activity as able
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Middle Stage
Manage and treat the symptoms that
accompanied by fever
Fever lasts for more than 3 days
Mouth and throat sores are present
Late Stage
Symptomatic, full-blown AIDS disease
Main objective: provide comfort or
palliative care
Treat all infections that affect intake
Modify diet according to symptoms
Maintain intake during periods of acute
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promoting
Hygiene
Food and water safety
intake by
Treating opportunistic infections
Treating pain
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Loss of Appetite
Eat small, frequent meals throughout
foods
Eat foods at room temperature or
cold
Eat soft and moist foods
Avoid caffeine and alcohol
Frequent mouth care
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an empty stomach
Eat dry bread or toast, and other plain dry
foods, in the morning preferably before getting
out of bed
Avoid foods with strong or unpleasant odors
Avoid fried foods
Avoid alcohol and coffee
Drink plenty of liquids
Avoid lying down immediately (at least 1 to 2
hours) after eating
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Diarrhea
Eat foods that travel slowly through the
symptoms improve
Avoid intake of fried and high fat foods
Dont eat foods with insoluble fiber
(roughage)
For example: Take the skin off fruits and
vegetables
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Diarrhea
Drink plenty of fluids (8-10 cups/day) to
prevent dehydration
Avoid sweet drinks, drink diluted juice
instead
Avoid very hot or very cold foods
If diarrhea is severe
Give oral rehydration solution
Food may be withheld for 24 hrs or restricted
Fever
Drink plenty of fluids
Eat small frequent meals, including
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Altered Taste
Use flavor enhancers such as salt
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chicken
foods
Eat fruits and vegetables and other lowfat foods.
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Fatigue, Lethargy
If possible, have someone pre-cook
foods
Food
Protein
(body-building
foods)
Carbohydrate
(energy-giving
foods)
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Food
Fruits/Vegetables
(source of many vitamins
and minerals)
Fats/Oils
(source of
fat soluble vitamins A, E,
D &k and energy)
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Foods to Avoid
Raw eggs
Undercooked chicken and meats
No raw, rare, or medium rare meats
without food)
Side effects with nutritional
consequences such as diarrhea or
nausea/vomiting
An effect on red blood cell production
causing anemia (e.g., Zidovudine - AZT)
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*Adapted from WHO, 2003: Nutrient requirements for People Living with HIV/AIDS, Report of technical
consultation. Geneva, WHO. Refer to this document for details and discussions on nutrient
requirements
transmission of HIV:
Appropriate health care during pregnancy (with ART)
Breastfeeding exclusively in the first 6 months and continue up to at least a
year
Replacement feeding if acceptable, feasible, affordable, sustainable and safe
(AFASS)
Asymptomatic HIV positive lactating women require the same increase in
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The Multidisciplinary
Team
A multidisciplinary team is crucial to
Lymphadenopathy
HIV/AIDS
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HIV/AIDS
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HIV/AIDS
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Oral Candidiasis
HIV/AIDS
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HIV/AIDS
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Infeksi
Cytomegalo
virus
(retina)
HIV/AIDS
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HIV/AIDS
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PML
HIV/AIDS
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Non-tuberculous
mycobacterial infx.
HIV/AIDS
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HIV/AIDS
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(shown) is a rare
cancer of the blood
vessels that is
associated with HIV. It
manifests as bluishred oval-shaped
patches that may
eventually become
thickened. Lesions
may appear singly or
in clusters.
Disseminated Mycosis
HIV/AIDS
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Conclusions
HIV affects nutrition by:
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