12.2.1 Poor nutrition and HIV: a vicious cycle
In this section you are going to look at the damaging cycle that can lead to a person with HIV and under-nutrition developing a variety of health problems including weakness, weight loss and loss of muscle tissue and fat. This cycle is represented in Figure 12.1. Vitamin and mineral deficiencies may occur at a time when a person actually has increased nutritional needs because of infections, viral replication and poor nutrient absorption. The whole body develops reduced immune functioning and increased susceptibility to opportunistic infections.
As you can see from Figure 12.1, the relationship between HIV and nutrition is multidirectional. HIV can cause or worsen undernutrition by making the person feel poorly and want to reduce their food intake at the same time as their body has increased energy requirements in an attempt to fight the infection. The disease itself may make the absorption of energy and other nutrients less efficient. Undernutrition in turn further weakens the immune system, increasing the risk of infection and worsening the disease’s impact. Box 12.1 summarises these points.
Box 12.1 The effects of under-nutrition on HIV
If a person living with HIV infection is under-nourished, they will have a weakened immune system that may lead to increased susceptibility to opportunistic infections. The person may also have a slow rate of healing from illnesses, possibly fast progression of the HIV disease state, and response to treatment may be poor.