New nutritional challenges emerge for HIV care providers

Nutritional therapy for HIV-infected patients is shifting focus. Drug treatments designed to combat the HIV virus have improved, decreasing some nutritional problems, while bringing others to light. As researchers from the Nutrition/Infection Unit in the Department of Public Health and Family Medicine at Tufts University School of Medicine describe in an editorial review and other research reports, new nutritional challenges in HIV/AIDS care have emerged.

The changes, according to Alice Tang, MS, PhD, assistant professor at Tufts University School of Medicine, and her colleagues, have resulted from the introduction of an advanced class of drugs called highly active antiretroviral therapy (HAART) over a decade ago.

In the past, the nutritional component of HIV/AIDS care was directed toward two major goals: supplying the vital nutrients that were often lost through poorly-functioning digestive tracts and minimizing weight loss. "The newer medications keep patients healthier overall, so we are not dealing with quite as much severe weight loss," says Tang. "Now we are able to concentrate more on determining the vitamin and mineral ('micronutrient') requirements of these patients and investigating potential therapeutic uses of supplements."

This is particularly important in the age of HAART, according to Tang, who has researched the role of antioxidants, like vitamin E, in HIV extensively. As it turns out, HAART medications, while controlling disease progression for many patients, may also increase oxidative stress. "Oxidative stress" refers to the state of imbalance that exists when chemically unstable by-products of metabolism exceed the body's capacity to quench them, either with its own natural antioxidants or with those obtained from the diet. The potential result of this imbalance is damage to cells and tissues. "Research efforts must focus on determining if this is, indeed, true. If so, what is the mechanism? Will dietary or supplement

Contact: Siobhan Gallagher
Tufts University

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