J Acad Nutr Diet. 2018 Mar;118(3):486-498. doi: 10.1016/j.jand.2017.12.007.
Nutrition is an integral component of medical care for people living with human immunodeficiency virus (HIV)/autoimmune deficiency syndrome (AIDS) (PLWHA). The Academy of Nutrition and Dietetics supports integration of medical nutrition therapy into routine care for this population. Fewer PLWHA experience wasting and undernutrition, while the prevalence of obesity and other chronic diseases has increased significantly. Improved understanding of HIV infection's impact on metabolism and chronic inflammation has only increased the complexity of managing chronic HIV infection. Nutrition assessment should encompass food insecurity risk, changes in body composition, biochemical indices, and clinical indicators of comorbid disease. Side effects from current antiretroviral therapy regimens are less prevalent than with previous generations of therapy. However, micronutrient deficiencies and chronic anemia also remain significant nutritional risks for PLWHA, making vitamin and mineral supplementation necessary in cases of acute deficiency or food insecurity. Additional factors can impact HIV-related nutrition care among the pediatric population, older adults, minority groups, those co-infected with tuberculosis or hepatitis, and PLWHA in rural or underserved areas. Registered dietitian nutritionists and nutrition and dietetic technicians, registered should participate in multidisciplinary care to incorporate nutrition into the medical management of PLWHA.
营养是为感染人类免疫缺陷病毒（HIV）/获得性免疫缺陷综合征（AIDS）的人（PLWHA）提供医疗护理的一个组成部分。营养与饮食学会支持将医学营养治疗整合到针对这一人群的常规护理中。较少的 PLWHA 经历消瘦和营养不良，而肥胖和其他慢性疾病的患病率显著增加。对 HIV 感染对新陈代谢和慢性炎症的影响的认识的提高，只是增加了慢性 HIV 感染管理的复杂性。营养评估应包括食物不安全风险、身体成分变化、生化指标和合并症的临床指标。与前几代治疗相比，目前抗逆转录病毒疗法方案的副作用不太常见。然而，微量营养素缺乏和慢性贫血仍然是 PLWHA 的重大营养风险，因此在急性缺乏或食物不安全的情况下需要补充维生素和矿物质。其他因素也会影响儿科人群、老年人、少数民族、同时感染结核或肝炎的人和农村或服务不足地区的 PLWHA 的与 HIV 相关的营养护理。注册营养师和注册营养技师、技术员应参与多学科护理，将营养纳入 PLWHA 的医疗管理。
