Supporting Advice for a Low Immune System

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This leaflet provides an introduction to diet and related guidance for people first diagnosed with HIV, who are taking ARVS or who's immune system is low.

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To limit the risk of infection via food, water and related behaviours for people at high risk i.e. CD4 count less than 200.

The target group will understand:

  • Healthy diet and good hygiene are crucial when your immune system is low.
  • How they should take their ARVs
  • The key points of food and water safety including storage, cooking/reheating and personal hygiene
  • How to minimise risk when eating away from home
  • CAMs can interfere with ARV medication and should only be taken with appropriate guidance.
  1. Choe PG, Choi HJ, Kim NH, Park WB, Song KH, Bang JH, Kim ES, Park SW , Kim HB, Oh MD, Kim NJ, High prevalence of low bone mass and associated factors in Korean HIV-positive male patients undergoing antiretroviral therapy. Journal of International Aids society (2014) 17;1:18773
  2. d'Ettorre G, Ceccarelli G, Giustini N, Serafino S, Calantone N, De Girolamo G, Bianchi L, Bellelli V, Ascoli-Bartoli T, Marcellini S, Turriziani O, Brenchley JM, Vullo V, Probiotics Reduce Inflammation in Antiretroviral Treated, HIV-Infected Individuals: Results of the "Probio-HIV" Clinical Trial. PloS one 2015, 10(9):e0137200
  3. Dolan SE; Kanter JR; Grinspoon S (2006) Longitudinal analysis of bone density in human immunodeficiency virus-infected women. Journal Of Clinical Endocrinology And Metabolism (2006). 91; 8: 2938-45. 006 May 30.
  4. Drain PK; Kupka R; Mugusi F; Fawzi WW (2007) Micronutrients in HIV-positive persons receiving highly active antiretroviral therapy American Journal of Clinical Nutrition (AM J CLIN NUTR), 2007 Feb; 85(2): 333-45
  5. Grobler L. Siegfried N, Visser M. et al Nutritional interventions for reducing morbidity and mortality in people with HIV. Cochrane database Feb 2013
  6. Ingle K. Gage-O`Brien S.The importance of the integration of a registered dietitian in the care of HIV positive patients  Journal Academy of Nutrition and Dietetics (2014) 114;9S: A 33
  7. Johns K, Beddall MJ, Corrin RC. (2005) Anabolic steroids for the treatment of weight loss in HIV-infected individuals. Cochrane Database Systematic Reviews. 2005 Oct 19;(4):CD005483.
  8. Koss C. Natureeba P. Nyafwono D. et al Brief Report: Food Insufficiency Is Associated With Lack of Sustained Viral Suppression Among HIV-Infected Pregnant and Breastfeeding Ugandan Women. Journal of Acquired Immune Deficiency Syndromes. 2016 Mar 1;71(3):310-5
  9. Mankal P. Kotler D. From Wasting to Obesity, Changes in Nutritional Concerns in HIV/AIDS Endocrinology and Metabolism Clinics of North America (2014) 43;3:647-663
  10. Ngo-Matip ME, Pieme CA, Azabji-Kenfack M, Biapa, Germaine N, Heike E, Moukette BM, Emmanuel K, Philippe S, Mbofung CM, Ngogang JY. Effects of Spirulina platensis supplementation on lipid profile in HIV-infected antiretroviral naïve patients in Yaounde-Cameroon: a randomized trial study. Lipids in Health and Disease 2014, 13:191
  11. NICE – Clinical Knowledge Summary 2015, HIV infection and AIDS - How should I manage acute HIV-related problems?
  12. Rivas P; Górgolas M; García-Delgado R; Díaz-Curiel M; Goyenechea A; Fernández-Guerrero ML (2007)Evolution of bone mineral density in AIDS patients on treatment with zidovudine/lamivudine plus abacavir or lopinavir/ritonavir. HIV Medicine Feb 2008; Vol. 9 (2), pp. 89-95. Date of Electronic Publication: 2007 Dec 18
  13. Sattler FR; Rajicic N; Mulligan K; Yarasheski KE; Koletar SL; Zolopa A; Alston Smith B; Zackin R; Bistrian B (2008) Evaluation of high-protein supplementation in weight-stable HIV-positive subjects with a history of weight loss: a randomized, double-blind, multicentre trial. The American Journal Of Clinical Nutrition 2008 Nov; Vol. 88 (5), pp. 1313-21.
  14. Succomanno M. Ammassari A. Bone disease in HIV infection Clinical cases Miner. Bone Metabolism (2011) 8;1:33-36 Journal of Acquired Immune Deficiency Syndromes (2015)  68 Supp.3S340-349
  15. Tang A. Quick T. Chung M. et al. Nutrition assessment, counselling and support interventions to improve health related outcomes in people living with HIV/AIDS: a systematic review of the literature. Journal of Acquired Immune Deficiency Syndrome. 2015 Apr 15;68 Suppl 3:S340-9.
  16. Wohl DA; Tien HC; Busby M; Cunningham C; Macintosh B; Napravnik S; Danan E; Donovan K; Hossenipour M; Simpson RJ Jr (2005) Randomized study of the safety and efficacy of fish oil (omega-3 fatty acid) supplementation with dietary and exercise counselling for the treatment of antiretroviral therapy-associated hypertriglyceridemia. . Clinical Infectious Diseases: An Official Publication Of The Infectious Diseases Society Of America 2005 Nov 15; Vol. 41 (10), pp. 1498-504. Date of Electronic Publication: 2005 Oct 11
  17. Woods MN; Wanke CA; Ling PR; Hendricks KM; Tang AM; Knox TA; Andersson CE; Dong KR; Skinner SC; Bistrian BR (2009) Effect of a dietary intervention and n-3 fatty acid supplementation on measures of serum lipid and insulin sensitivity in persons with HIV. American Journal of Clinical Nutrition, 2009 Dec; 90(6): 1566-78 (60 ref)
  18. Wright L. Epps J. Nutrition risk and complications in HIV AIDS: the impact of food security, Topics in Clinical Nutrition (2014) 29;4:288-293
NDR-UK Ref No: 9386E
Classification: HP
Related Printed Version: 9386
Publication Date: 01/14
Last Review: 2017
Last Update: 2020

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