What are the WHO guidelines for nutritional assessment in adults with HIV infection?

Updated: Apr 09, 2019
  • Author: Fazia Mir, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Answer

With regard to nutrition assessment:

  • Measure weight, weight change, height, BMI, and mid upper-arm circumference (MUAC).

  • Assess appetite, difficulty swallowing, nausea, diarrhea, and drug-food interaction effects.

  • Assess household food security.

With regard to malnutrition:

  • Mild to moderately malnourished adults (BMI < 18.5 kg/m2), regardless of HIV status, should receive supplementary feeding. Usually, fortified blended foods, such as corn-soya blend (CSB), are provided, but compressed bars or biscuits and lipid-based nutrient supplements (pastes) may also be used.

  • Severely malnourished adults (BMI < 16 kg/m2) should receive a therapeutic food, nutritionally equivalent to F100.

  • For initial treatment of severely malnourished adults aged 19 to 75 years, energy intake should be 40 kcal/kg/day; for initial treatment of those aged 15-18 years, energy intake should be 50 kcal/kg/day.

With regard to dietary intake:

  • Energy intake in asymptomatic HIV infection should be increased by 10%.

  • During infection, the aim should be to reach the maximum achievable intake of 20-30% above normal intake; during the recovery phase, intake should be increased to the maximum extent possible.

  • Multivitamin supplements should be started.


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