Ernährungsmedizinische Aspekte der HIV-Infektion: Nicht mehr nur Wasting!

Zusammenfassung

Der Schwerpunkt einer ernährungsmedizinischen Betreuung von HIV-(human immunodeficiency virus) infizierten Patienten in den westlichen Industrienationen hat sich aufgrund der besseren antiretroviralen Therapiemöglichkeiten (highly active antiretroviral therapy - HAART) gewandelt. Während früher die ernährungsmedizinische Betreuung von HIV-infizierten Patienten durch das so genannte „Wasting-Syndrom” geprägt war, treten jetzt die metabolischen Nebenwirkungen der HAART wie Lipodystrophie, Hyperlipidämie oder gestörte Glukosetoleranz zunehmend in den Vordergrund. Zu den bisherigen Zielen einer Ernährungstherapie, wie Optimierung oder Erhalt des Ernährungszustandes, müssen künftige Empfehlungen für Patienten mit HIV-Infektion die ungünstigen Nebeneffekte der medikamentösen Therapie einbeziehen. Dieser Artikel soll auf die unterschiedlichen ernährungsmedizinischen Therapiemöglichkeiten wie Gewichtsmonitoring und verschiedene Diätregime bei HIV hinweisen und führt auf, wann ein zusätzliches körperliches Trainingsprogramm sinnvoll sein kann.

Abstract

Patients with human immunodeficiency virus (HIV) infection commonly experience a variety of nutritional problems. However, the availability of new highly active antiretroviral therapy (HAART) for the treatment of AIDS decreased the incidence of the wasting syndrome parallel to a decrease in morbidity and mortality. But therapy side effects such as nutritional and metabolic problems of HAART, like hyperlipidemia, fat redistribution and diabetes mellitus, make the use of HAART problematic. In this report we discuss basic dietary and metabolic problems appearing in HAART therapy and provide practical suggestions for their management. This information is intended to raise health care providers' attention to focus on nutritional problems in their patients, including monitoring of weight, dietary issues and relevant symptoms. Additionally we encourage physicians to cooperate with experienced dietitians and exercise trainers.

Schlüsselwörter

HIV-Infektion - Ernährung - Mangelernährung - Ernährungszustand - Stoffwechsel - Therapie

Key words

Acquired immunodeficiency syndrome - nutrition - body composition - metabolism - therapy

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