causes 3 million deaths worldwide each year, 95% of
them in developing countries.
Nutritional issues are common in patients with
HIV infection. Some problems with diet and nutrition
are caused by HIV infection directly while others are
related to opportunistic infections or medication side
effects. Maintaining adequate food intake and bal-
anced nutrition in patients with HIV infection is com-
plicated not only by the many ways in which the
disease can affect the body—including the fact that
the virus mutates rapidly—but also by frequent updat-
ing of treatment strategies for AIDS, including nutri-
tional therapy. As a result, nutritional care of patients
with AIDS must be tailored to each person and
reviewed carefully every few months. In 2004, the
American Dietetic Association (ADA) and the Dieti-
tians of Canada (DC) issued a position statement on
the care of persons with HIV infection that said, ‘‘Indi-
vidualized nutrition care plans will be an essential
feature of the medical management of persons with
HIV infection and AIDS.’’ The ADA has a specialized
dietetic practice group (DPG) for AIDS and HIV
patients that can be contacted from the website listed
below.OriginsAIDS is a relative newcomer to the list of major
infectious diseases. According to the National Insti-
tutes of Health (NIH), researchers think that HIV
originated in a species of chimpanzees native to west
equatorial Africa and jumped the species barrier into
humans through hunters’ contact with the blood of
infected chimpanzees—most likely somewhere in
western Africa in the second half of the twentieth
century. The earliest known case of HIV infection
was found in a blood sample collected from a man in
Kinshasa in the Congo in 1959.
The first cases of AIDS were not diagnosed in the
United States until June 1981, when the CDC reported
a cluster of five cases of an opportunistic lung infec-
tion among homosexual men in Los Angeles. In the
first 15 years of the epidemic, there were no effective
treatments for HIV infection (there is still no cure as of
2007). As a result, many patients turned to alternative
dietary treatments to help them manage the nausea,
weight loss, and other symptoms associated with the
infection. Alternative food-related therapies that were
used in this period included:
Herbal compounds used in traditional Chinese med-
icine (TCM) for the treatment of fevers or energy
deficiency, particularly medicines containing astra-
galus (Astragalus membranaceus).
Western herbal preparations recommended by
naturopaths, including goldenseal (Hydrastis cana-
densis), licorice (Glycyrrhiza glabra), osha root (Lig-
usticum porteri), and echinacea.
Detoxification diets, including the Master Cleanser
lemon juice diet.
Juice fasts, often taken together with laxatives or
colonics.
Nutritional supplements, particularly blue-green
algae, zinc, vitamin C, beta-carotene, and catechin
(an antioxidant).
Vegetarian and raw food diets.
Prior to 1996, nutritional management of AIDS
patients focused largely on weight loss and wasting,
sometimes called the ‘‘slim disease.’’ After the intro-
duction of highly active antiretroviral therapy
(HAART) in 1996, however, nutritionists were con-
fronted with a range of other dietary problems related
either to the new drugs or to prolonged survival itself.The AIDS virus.(National Institutes of Health.)
AIDS/HIV infection