Diagnostik und Therapie von Malnutritionssyndromen bei HIV-Infektion/AIDS und Mukoviszidose

Abstract

Diagnostic and Therapy of Malnutrition of HIV-Infection/AIDS and cystic fibrosis

Introduction:
Malnutrition is a frequent risk factor of both HIV-infection and cystic fibrosis. Because malnutrition influences the mortality and morbidity of both diseases, early assessment and treatment of malnutrition is very important

Design:
At the Justus-Liebig-University individualized Nutritional Support was offered over a period of two years to outpatients with HIV-infection and cystic fibrosis, after evaluation of their nutritional status. The present study was designed to assess the change of the nutritional status and prevention of a potential malnutrition during the investigation period.

Patients and Methods:
Data of 10 HIV-infected patients (stages B; C) and 123 CF-Patients (age 0-38) were analysed. Beside anthropometric parameters, the body composition of both patient-groups was determined by bioelectrical impedance analysis. The resting energy expenditure of the HIV-infected patients was measured with indirect calorimetry. Biochemical parameters of nutrition were determined from serum samples. Dietary intake was assessed using 7-day protocols at home. The patients with cystic fibrosis were also asked to document pancreatic enzyme replacement therapy.

Results:
At both time points the BMI of the HIV-infected patients was within normal range, despite some changes in weight. The evaluation of the nutrition recalls demonstrate a restricted total energy intake, but a higher protein intake. There was no sign of protein malnutrition. The energy intake of the CF-patients could not be increased, but the fat and enzyme intake were both increased. The successful nutritional counseling resulted in the stabilisation of the LSG and in the increases in BMI.

Conclusions:
Nutritional support and therapy are mandatory at an early stage of the disease and should be implemented by a qualified and experienced dietician or nutritionist.