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The Centers for Disease Control and Prevention define AIDS wasting as involuntary loss of more than 10% of body weight, and more than 30 days of Diarrhea, or weakness and fever. The AIDS wasting syndrome leads
to loss of body fat and, more importantly, to the loss of
lean body cell mass, which is mostly muscle. Such a wasting
syndrome is an ominous sign of disease progression and
impending death.
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- In fighting the acquired immune
deficiency virus, the body also spends extra energy in
manufacturing Proteins such as cytokines
to fight the virus, thereby accelerating use of much
needed nutrients and calories.
- Consequently, patients with AIDS will need more calories to maintain
normal body weight and nutritional balance. Other factors
that add to the wasting syndrome (i.e., poor appetite and
inadequate food intake) may be due to the effects of the
infection itself, or may be associated with symptoms of the
disease (mouth lesions, pain upon swallowing etc.), or a
result of the potent HIV medications.
- In addition, numerous infections that
accompany AIDS (parasites, etc.) and the side
effects of AIDS therapy can adversely affect the
intestine (e.g., Diarrhea, nausea, vomiting) where
important nutrients are normally absorbed, thus contributing
to the wasting syndrome.
- Factors such as fatigue and social
isolation only make it more difficult for some one with AIDS to shop and adequately take care of his or
her nutritional needs.
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Examination:
- May be normal
- Signs & symptoms of
AIDS-defining illnesses (see below)
- Laboratory Findings:
- HIV antibody test -- the HIV virus
multiplies in the body for weeks or months before the body
responds by making antibodies to it, at which time the HIV
test is considered positive. Decreased CD4 lymphocyte (also
known as T-helper cells) count (the lower the count the more
likely to develop infections and illness)
- Symptoms begin to occur with CD4
count falling below 350/ml
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Anemias
- Polyclonal
hypergammaglobulenimia
- High cholesterol
- Skin antigen testing fails to
react to typical
antigens
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- Nutritional consultation is
recommended.
- Treat all opportunistic infections (see AIDS)
- Megace and Marinol (synthetic
marijuana) are appetite stimulants helpful in some cases.
- Supplements such as Ensure and
Advera and protein shakes made according to the suggestions
of a dietician can be helpful too.
- Hormones such as growth hormone and
anabolic steroids may help in some.
- Vitamin and minerals assessment and
supplementation must be considered.
- Nasogastric tube feeing, gastric
tube feeding, and other ways of providing extra nutrients
and calories may be considered.
- See additional treatment of HIV under AIDS or Acquired Immune Deficiency Syndrome.
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