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Nutrition and immune function in human immunodeficiency virus infection

Published online by Cambridge University Press:  28 February 2007

Derek C. Macallan
Derek C. Macallan*
Affiliation:
Division of Infectious Diseases, St George’s Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK
*
Corresponding Author: Dr D. C. Macallan, fax +44 (0)181 725 3487, email [email protected]
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Abstract

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The triad of human immunodeficiency virus (HIV) infection, nutritional status and immune function are intimately related, each factor having effects on the others. The dominant effect in this three-way relationship is the effect of HIV infection on nutritional status, an effect which, until the advent of potent anti-retroviral drugs, has been manifest primarily as wasting. Recently, more complex metabolic abnormalities have become apparent, particularly fat redistribution syndromes, hyperlipidaemia and hypercholesterolaemia. For the converse effect, the effect of nutritional state on HIV disease progression, there is good evidence that clinical outcome is poorer in individuals with compromised nutrition. However, the beneficial effects of nutritional support have been more difficult to demonstrate. For macronutrients, effective macronutrient supply improves survival in severely-malnourished individuals and may have beneficial effects in less-severely-affected individuals. Micronutrient deficiencies appear to be involved in modifying clinical HIV disease and may also be associated with enhanced mother-to-child transmission of virus, particularly in developing countries. Intervention trials in this setting are currently under way. In conclusion, the interaction of HIV infection and nutrition is of great importance not just because of the major impact that HIV infection has on nutritional state, but also because strategies to improve nutritional status, both quantitatively and qualitatively, may have a beneficial effect on the clinical and immunological course of the disease.

Keywords

HIV infectionAIDSNutritional statusWastingMicronutrients
Type
Symposium on ’Nutrition, infection and immunity‘
Information
Proceedings of the Nutrition Society , Volume 58 , Issue 3 , August 1999 , pp. 743 - 748
Copyright
Copyright © The Nutrition Society 1999

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