title: Recommendations from SPNS/GEAM/SENBA/SENPE/AEDN/SEDCA/GESIDA on nutrition in the HIV-infected patient.
abstract: OBJECTIVE
  to make recommendations on the approach to nutritional problems (malnutrition, cachexia, micronutrient deficiency, obesity, lipodystrophy) affecting HIV-infected patients.
  
  
  METHODS
  these recommendations have been agreed upon by a group of expertes in the nutrition and care of HIV-infected patients, on behalf of the different groups involved in drafting them. Therefore, the latest advances in pathophysiology, epidemiology, and clinical care presented in studies published in medical journals or at scientific meetings were evaluated.
  
  
  RESULTS
  there is no single method of evaluating nutrition, and diferent techniques--CT, MRI, and DXA--must be combined. The energy requirements of symptomatic patients increase by 20-30%. There is no evidence to support the increase in protein or fat intake. Micronutrient supplementation in only necessary in special circumstances (vitamin A in children and pregnant woman). Aerobic and resistance excercise is beneficial both for cardiovascular health and for improving lean mass and muscular strength. It is important to follow the rules of food safety at every stage in the chain. Therapeutic intervention in anorexia and cachexia must be tailored, by combining nutritional and pharmacological support (appetite stimulants, anabolic steroids, and, in some cases, testosterone). Artificial nutrition (oral supplementation, enteral or parenteral nutrition) is safe and efficacious, and improves nutritional status and response to therapy. In children, nutritional recommendations must be made early, and are a necessary component of therapy.
  
  
  CONCLUSIONS
  appropriate nutritional evaluation and relevant therapeutic action are an essential part of the care of HIV-infected patients.
authors.affiliation: Plan Nacional sobre el Sida, España.
authors.forename: R
authors.initials: R
authors.lastname: Polo
authors.forename: C
authors.initials: C
authors.lastname: Gómez-Candela
authors.forename: C
authors.initials: C
authors.lastname: Miralles
authors.forename: J
authors.initials: J
authors.lastname: Locutura
authors.forename: J
authors.initials: J
authors.lastname: Alvarez
authors.forename: F
authors.initials: F
authors.lastname: Barreiro
authors.forename: D
authors.initials: D
authors.lastname: Bellido
authors.forename: E
authors.initials: E
authors.lastname: Câncer
authors.forename: D
authors.initials: D
authors.lastname: Cánoves
authors.forename: P
authors.initials: P
authors.lastname: Domingo
authors.forename: V
authors.initials: V
authors.lastname: Estrada
authors.forename: C R
authors.initials: CR
authors.lastname: Fumaz
authors.forename: M J
authors.initials: MJ
authors.lastname: Galindo
authors.forename: T
authors.initials: T
authors.lastname: García-Benayas
authors.forename: C
authors.initials: C
authors.lastname: Iglesias
authors.forename: J A
authors.initials: JA
authors.lastname: Irles
authors.forename: I
authors.initials: I
authors.lastname: Jiménez-Nacher
authors.forename: F
authors.initials: F
authors.lastname: Lozano
authors.forename: I
authors.initials: I
authors.lastname: Marqués
authors.forename: J R
authors.initials: JR
authors.lastname: Martínez-Alvarez
authors.forename: M J
authors.initials: MJ
authors.lastname: Mellado
authors.forename: A
authors.initials: A
authors.lastname: Miján
authors.forename: J T
authors.initials: JT
authors.lastname: Ramos
authors.forename: P
authors.initials: P
authors.lastname: Riobo
mesh_terms: D000465:Algorithms; D015658:HIV Infections / Q000150:complications* / Q000523:psychology; D006801:Humans; D044342:Malnutrition / Q000209:etiology* / Q000628:therapy*; D009751:Nutritional Requirements; D018529:Nutritional Support