HIV/AIDS

Question 1

high risk populations

Answer 1

• male-to-male sexual contact
• heterosexual with more than one partner
• IV drug users
• homeless/mentally ill

low risk now - mother to child and blood transfusions

Question 2

HIV transmission routes

Answer 2

• unprotected sex
• contaminated needles
• contaminated blood products
• perinatal - across placenta, during birth, breastfeeding

Question 3

4 stages of HIV

Answer 3

(1) acute HIV infection
(2) asymptomatic HIV infection
(3) symptomatic HIV infection
(4) AIDS

Question 4

Acute HIV infection stage

Answer 4

• lasts about 2 weeks - test positive 8-12 weeks later
• rapid viral replication
• flu-like symptoms

Question 5

Asymptomatic HIV stage

Answer 5

• few if any noticeable symptoms
• can last for many years
• may be subclinical changes - decrease in LBM, vit B12 deficiency, increased susceptibility to food and water pathogens

Question 6

Symptomatic HIV stage

Answer 6

• symptoms of fevers, sweats, skin problems, fatigue, other nonspecific symptoms
• decline in nutritional status or body comp

Question 7

AIDS stage

Answer 7

• at least one well-defined life threatening clinical condition that can be linked to HIV-induced immunosuppression
• CD4 (T-helper) less than 200

Question 8

opportunistic infections

Answer 8

• cancers - non-Hodgkins lymphoma, Karposi’s sarcoma, cervical cancer
• neuromuscular diseases
• HIV - liver disease
• HIV - nephropathy
• TB and lung disease
• GI and pancreatic issues

Question 9

HIV MNT goals

Answer 9

(1) support healthy immune system
(2) maintain LBM
(3) minimize nutrition-related complications that interfere with intake or absorption
(4) food-medication interactions
(5) enhance quality of life

Question 10

HALS (HIV associated lipodystrophy syndrome)

Answer 10

• protease inhibitors may cause
• disturbed fat metabolism
• wasting of face and limbs
• redistributed in abdomen, inside body cavity or between shoulder blades (buffalo hump)

Question 11

pediatric considerations

Answer 11

• low height and weight
• monitor growth and development
• monitor immune function (CD4%, not number)
• assess every 1-6 m
• multidisciplinary team

Question 12

CAM (complimentary alternative therapies)

Answer 12

(1) is it harmful?
(2) harmful interactions with meds?
(3) delaying effective treatments?
(4) does it work?
(5) financial expense worth the benefit?

Question 13

specific CAM to avoid

Answer 13

(1) St. John’s wort - interacts with ART
(2) garlic - high levels interact with ART
(3) milk thistle - blocks/interacts with drugs