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Being Alive
NUTRITION AND HIV INFECTION: Introduction
Walt Senterfitt
February 5, 1993
Being Alive 1993 Feb 5: 2

The central premise of the symposium was that medical care providers tend to overlook or minimize the role of nutrition and malnutrition in the length and quality of life with HIV/AIDS. Reasons for this serious omission range from the long-standing inattention to nutrition in medical school curricula, to providers' being overwhelmed by the complexities of managing more familiar drug therapies, to the perceived absence of effective nutritional therapies, to the simple lack of recognition that malnutrition is the proximate cause of a majority of AIDS deaths.

The association of weight loss with increased fatigue, increased dependence on others, decreased response to treatment, shortened life expectancy and overall decrease in the quality of life is well known to the PWA community. One presenter put it, perhaps rather too crudely, albeit for shock effect, "skinny=death." What was striking in emphasis, to the providers at least, was the assertion by Dr. Cimoch that "the vast majority of AIDS deaths are actually due to protein-calorie malnutrition, which is a disease in and of itself, and needs to be recognized, evaluated and treated as such." In other words, the same attention that is presently given to the status and progression of primary HIV infection (through monitoring T-cells and viral markers and treatment with antiviral drugs) and the prevention and treatment of opportunistic infections like PCP, CMV, and MAC should be given to nutritional status and problems. The principles of early and continuous monitoring, prophylaxis, rapid and aggressive treatment, and integration of nutrition with all other modes of care are mandatory. 

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