BACKGROUND
Patients with HIV infections often present with complications and symptoms which compromise immune and nutrition status. MNT is important to reestablish and conserve nutritional status in the situation of chronic infection.
CLIENT HISTORY
A young Chinese male referred to the dietitian for provision of high energy, protein diet. Patient has an underlying history of Retroviral Disease (RVD) and latent Syphilis.
ASSESSMENT
Presented with low BMI and severe weight loss. Poor oral intake which reflected in his biochemistries. NFPE showed severe malnutrition with presence of oral thrush due to fungal infection resulting in difficulty in eating.
NUTRITION DIAGNOSIS
Inadequate oral intake related to physiological causes increasing nutrient needs concerning retroviral disease as evidenced by weight loss, energy and protein intake of less than 20% when compared to requirements, severe malnutrition and underlying disease of RVD.
OBJECTIVE OF MANAGEMENT & NUTRIENT PRESCRIPTION
To provide adequate energy and protein through oral nutrition supplement and hospital diet to improve nutritional status. Energy prescription of 2160kcal/day and 2g protein/kg/day with careful delivery to address risk of re-feeding syndrome by starting with 25% to 50% of the total requirement. Nutrition intervention focused on soft hospital diet and ONS based on patient’s preference.
OUTCOME AND FOLLOW-UP
Improvement in energy and protein intake through compliance within 1 week indicated success in meeting nutritional needs. Weight changes, biochemical data and NFPE should be monitored continuously.
DISCUSSION
Case exemplifies importance of adequate nutrition through individualized intervention to achieve desired outcomes for beneficial HIV nutrition management.
LEARNING POINTS/TAKE HOME MESSAGES
• Improvement and maintenance of nutritional status can be achieved through successful nutrition intervention
• Patient-centered nutrition care is important to support a more successful nutrition-related therapies
• Improve in the selection of ONS with the use of semi-elemental formula which indicated to improve in gut barrier function, immune response, digestion and absorption.
