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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although malnutrition and wasting are known features of human immunodeficiency virus (HIV) infection, their incidence and possible association with immunologic impairment are largely unknown, as is the prognostic value of the nutritional state. Nutritional, clinical, and immunologic parameters were measured in 100 outpatients in different stages of HIV infection. In addition, 39 patients with AIDS were prospectively followed for a mean period of 343 (range, 53-650) days. Sixty-three percent of the patients showed evidence of malnutrition, 21% suffered from wasting. A reduced body cell mass and decreased serum albumin levels were observed in 32 and 14%, respectively, predominantly in more advanced disease stages. Fourteen of 39 AIDS patients died after a mean survival of 212 days. Survivors showed significantly larger initial body cell mass values and higher initial serum albumin levels compared with nonsurvivors, whereas CD4+ lymphocyte counts, disease complications, and medication were all similar in both groups. Kaplan-Meier analyses revealed a significantly prolonged survival in patients with a body cell mass > 30% of body weight or serum albumin levels exceeding 30 g/L. Factor analyses indicated that the parameters of nutritional state were independent from each other and from CD4+ lymphocyte counts. Malnutrition occurs frequently during HIV infection and increases with disease progress. It strongly predicts patient survival independent of CD4+ lymphocyte counts.
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PMID:Incidence and prognostic value of malnutrition and wasting in human immunodeficiency virus-infected outpatients. 785 35

The immune system is impaired by either malnutrition or human immunodeficiency virus infection. When these occur together, their compounding effects promote altered metabolism, inadequate intake, and malabsorption, which further impair immune function and contribute to human immunodeficiency virus wasting. Careful dietary management can help meet nutritional needs without further compromising the immune status of the person living with acquired immune deficiency syndrome.
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PMID:AIDS and malnutrition: dual assaults on the body. 786 Mar 43

The prevelance of IDA in industrialized countries has declined in recent decades, but there has been little change in the worldwide prevalence. IDA is currently estimated to affect more than 500 million people. Recent studies have indicated that anemia per se, the most common manifestation of iron deficiency, is less important from a public health standpoint than liabilities associated with tissue iron deficiency. The most important of the latter are an impairment in psychomotor development and cognitive function in infants and preschoolers, a deficit in work performance in adults, and an increase in the frequency of low birth weight, prematurity, and perinatal mortality in pregnancy. There have been several recent advances in combatting nutritional iron deficiency. One of the major problems has been in distinguishing iron deficiency from other causes of anemia seen epidemiologically such as malaria, HIV infection, chronic inflammation, hemoglobinopathies, and protein energy malnutrition. When combined with serum ferritin and hemoglobin determinations, the serum transferrin receptor assay is a valuable addition in epidemiologic surveys because it provides a quantitative measure of functional iron deficiency and it distinguishes true IDA from the anemia of chronic disease. The most difficult challenge is to develop effective methods of supplying iron to large segments of a population. Supplementation with iron tablets is suitable for only brief periods of need such as during pregnancy. The poor compliance with existing supplementation programs is believed to be due mainly to the gastrointestinal side effects of oral iron which can be eliminated by the use of a gastric delivery system. The most effective long-term strategy is to increase the intake of bioavailable iron in the diet. The customary approach has been to fortify a food staple such as wheat, rice, sugar, or salt, and thereby increase the iron intake of the entire population. However, because of concerns about the risk of cancer and heart disease in individuals with high iron stores, there is an increasing reluctance to supply iron to individuals who do not require it. A more effective strategy is to fortify food vehicles that are targeted to segments of the population at greatest risk of iron deficiency such as infants and school children. Because of the strong inhibitory properties of diets in regions of the world where iron deficiency is most prevalent, the use of NaFeEDTA has important advantages for food fortification.
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PMID:Iron deficiency: the global perspective. 788 26

People's concerns with how others perceive and evaluate them can lead to behaviors that increase the risk of illness and injury. This article reviews evidence that self-presentation motives play a role in several health problems, including HIV infection; skin cancer; malnutrition and eating disorders; alcohol, tobacco, and drug use; injuries and accidental death; failure to exercise; and acne. The implications of a self-presentational perspective for research in health psychology, the promotion of healthful behaviors, and health care delivery are discussed.
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PMID:Self-presentation can be hazardous to your health: impression management and health risk. 788

Breast feeding has been recognized as a mode of HIV transmission since 1985. It is estimated that infants run 1-in-3 risk of being infected with HIV when breast fed by mothers who were initially infected with HIV after delivery. Breast feeding, however, is unlikely to confer such as a high risk to the child when the mother is infected before delivering the child. Acknowledging the risk of infection, the World Health Organization (WHO) in 1987 nonetheless recommended that mothers continue to breast feed. An analysis subsequent to that recommendation, however, suggested that breast feeding may increase the rate of perinatal HIV transmission by 14% and may be the cause of higher perinatal HIV transmission rates seen in some developing countries. Even so, WHO/UNICEF still recommend that, in a setting of high infant mortality associated with infectious disease or malnutrition, all women should breast feed their infants. Breast feeding is not recommended in more affluent settings. This recommendation is made and maintained as the less of 2 evils; bottle feeding infants in some settings may threaten child survival more than breast feeding them with potentially infected milk. The paper describes the attempt of HU et al to compare the hazards of bottle feeding and the risks of perinatal acquisition of HIV through a decision analysis model. It remains to be seen which approach should be adopted to truly maximize the long-term potential survival of these infants.
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PMID:Breast feeding and HIV. 790 77

Plasma concentrations of 21 amino acids were determined for 20 control subjects and 20 subjects infected with human immunodeficiency virus type 1 (HIV). Compared with the control subjects, the HIV-infected group had lower cystine, tryptophan, and methionine (decreased 67%, 52%, and 32%, respectively, P < 0.001 for each) and increased taurine (230%, P < 0.001) and lysine concentrations (30%, P < 0.001). Other amino acid concentrations changed modestly. Amounts of cystine, tryptophan, methionine, taurine, and lysine did not differ significantly between subgroups of HIV-infected subjects with > 200 (n = 6) or < 200 (n = 14) CD4+ lymphocytes per microliter, suggesting that the concentrations decrease soon after infection and change little thereafter. Activation of metabolism of cystine to taurine may explain reciprocal changes in these amino acids and known depletion of cystine and glutathione. The selective changes in amino acid profiles observed during HIV infection differ from those recognized for malnutrition or other pathological processes.
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PMID:Changes in plasma amino acid concentrations in response to HIV-1 infection. 790 26

Women and children are the people most affected by civil strife and food crises. A country's successful response to crises will depend on its preexisting infrastructure in the health and social sectors and its development status. The 1992 world refugee population was 16 million, which was a growth of about 500% since 1970. Another 1.2 million have been internally displaced. Over 300 million people in 1992 had homes or livelihoods destroyed by disaster. About 60% of disasters requiring external assistance have been due to floods and winds. Famines and drought do not occur as frequently, but have more long lasting effects on land and population; most recently, famines and droughts have stemmed from armed conflicts. Civil conflicts have claimed the most victims: almost 3 times as many civilians as soldiers. Food recently has been used as a weapon of war. The use of landmines in civil conflicts has resulted in growing numbers of civilian disabled. Millions of children have been abandoned or separated from their families due to armed conflicts. Sexual violence as a weapon of war against civilians results in high rates of pregnancy, sexually transmitted diseases and HIV, as well as psychological traumas. The mental illness or stress disorders from armed conflicts or refugee and abandonment status have been neglected as outcomes. Natural and civil disasters engender malnutrition and disruptions of breast feeding. Early immunization may not be possible under crisis conditions.
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PMID:Natural and man-made disasters: the vulnerability of women-headed households and children without families. 801 82

The notion of risk underlying the concept of vulnerability implies that everyone is potentially vulnerable (or at risk), that is, there is always a chance of developing health problems. The risk is, however, greater for those with the least social status, social capital, and human capital resources to either prevent or ameliorate the origins and consequences of poor physical, psychological, or social health. The completeness and accuracy of information on the health status of the vulnerable populations examined here varies substantially across groups. Methodological work is needed to derive standardized definitions of terms, specify the content and timing for collecting information for minimum basic data sets, and develop uniform standards for evaluating and reporting data quality on the health status of vulnerable populations. The variety of indicators of vulnerable populations examined indicates that during the decade of the 1980s the incidence of serious physical, psychological, and/or social needs increased (at worst) and was unameliorated (at best) for millions of Americans. AIDS emerged as a new and deadly threat from a handful of cases classified as Gay-Related Immune Deficiency in the early part of the 1980s to what now may be over a million Americans who are HIV-positive. The number of homeless has increased an average of 20% a year to estimates now ranging up to one million men, women, or children homeless on any given night to twice that number who may be homeless sometime during the year. Over seven million people immigrated to the United States during the period from 1981 to 1990--an increasing proportion of whom are refugees carrying with them the physical, psychological, and social wounds of war. The number of children abused by family members or other intimates has burgeoned to an estimated 1.6 to 1.7 million per year, and with the greater use of firearms, intentional acts of violence towards oneself or others are becoming increasingly deadly in their consequences. Though fewer Americans smoke, drink, and use illicit drugs in general than was the case earlier in the decade of the 1980s, the use of cocaine (and particularly crack) among hard-core addicts has resulted in increases in the number of drug-related deaths.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Health status of vulnerable populations. 805 96

There are increasing challenges for the practising gastroenterologist in treating AIDS-related gastrointestinal diseases. The differential diagnoses of dysphagia and odynophagia include cytomegalovirus (CMV) and herpes simplex virus (HSV) infection, non-specific aphthous ulceration and non-AIDS oesophageal diseases, especially reflux oesophagitis. Chronic subacute abdominal pain with nausea, vomiting, early satiety and weight loss is suggestive of an obstructive lesion caused by lymphoma or Kaposi's sarcoma. Severe acute abdominal pain can indicate pancreatitis or intestinal perforation due to cytomegalovirus. Right upper quadrant pain (with or without fever, vomiting or abnormal liver function tests with a cholestatic profile) is suggestive of hepatobiliary pathology including cholecystitis, cholangitis, acalculous cholecystitis and AIDS cholangiopathy. Diarrhoea is the most common gastrointestinal symptom of AIDS, affecting 50-90% of patients. Causes of AIDS diarrhoea include protozoa (Cryptosporidium parvum, Isospora belli, Enterocytozoon bieneusi, Septata intestinalis, Cyclospora spp, Entamoeba histolytica and Giardia lamblia), bacteria (Mycobacterium avium-intracellulare, Clostridium difficile, Salmonella, Shigella and Campylobacter jejuni), and viruses (CMV, HSV and possibly HIV). Chronic diarrhoea, malnutrition and weight loss can shorten the life-span of patients with AIDS. Elemental diets, isotonic formulas, medium chain triglycerides and total parenteral nutrition have been tried with little success in AIDS patients with severe diarrhoea and wasting.
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PMID:AIDS and the gut. 805 32

The relationships among nutritional status, infectious disease, and the immune system suggest that nutrition may be a cofactor in human immunodeficiency virus (HIV) progression. We examined nutrition as a cofactor in HIV disease by reviewing the current literature on the interactions of nutrition, infectious disease processes, and immune system dysfunction. Studies demonstrate that poor nutritional status and infection affect the immune system and interact with each other. This relationship leads to the development of opportunistic infections and malignancies, which may result in a diagnosis of acquired immunodeficiency syndrome. Moreover, evidence from our review indicates that nutritional status may play a role in HIV disease progression. We recommend that clinical trials be conducted to evaluate general malnutrition and the efficacy of supplementation with specific nutrients at various stages of HIV disease.
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PMID:Nutrition: a cofactor in HIV disease. 807 83


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