Nutrition and metabolic management of AIDS during acute illness.

Diarrhea, sepsis, and malnutrition in the AIDS population are common. Some authors have predicted length of survival based on malnutrition biomarkers alone (degree of weight loss at presentation and serum albumin). Similarly, the hypothesis that malnutrition creates a vicious cycle that potentiates susceptibility to opportunistic infections may be valid. Consideration should be given to combining aggressive enteral and parenteral support with metabolic support in the acute phase of illness and between bouts of infections to facilitate patient care and to restore lean tissue. A skilled nutritional support service can deliver needed metabolic support along with nutritional support to these patients. In this case, we focused on the challenges of treating a new patient with significant malnutrition associated with AIDS of unknown duration; untreated gastrointestinal pathogens associated with substantial acid-base, electrolyte, and micronutrient deficiency; and systemic sepsis.