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HIV/AIDS

H/A: Introduction (2010)

Guideline Title

HIV/AIDS (2010) Evidence-Based Nutrition Practice Guideline

Guideline Narrative Overview

The focus of this guideline is on medical nutrition therapy (MNT) for individuals with HIV/AIDS.

The primary goals of MNT are:

  • To delay HIV disease progression
  • To prevent and treat malnutrition
  • To maximize food and water safety practices
  • To minimize the impact of other comorbidities on the progression of HIV infection, from birth through adulthood.

Guideline Development 

This guideline is intended for use by Registered Dietitians (RDs) involved in providing MNT to individuals with HIV/AIDS. The application of the guideline must be individualized to assist the Registered Dietitian to successfully integrate MNT into the overall medical management of individuals with HIV/AIDS.  The recommendations in the guideline were based on a systematic review of the literature.
   
The recommendations are based on the work performed by the American Dietetic Association HIV/AIDS expert working group. The number of supporting documents for these topics is below:
  • Recommendations: Nineteen (19)
  • Conclusion Statements:  Thirteen (13) 
  • Evidence Summaries:  Thirteen (13)
  • Article Worksheets: One hundred and fifty-two (152).
At the time of this publication, the majority of research has been completed in the adult population; therefore, clinical judgment is crucial in the application of these guidelines for individuals in other age groups and settings.
 
To view the guideline development and review process, click here.

Contributors 

See Project Team for the list of expert workgroup members, analysts and contributors for this project.

Application of the Guideline

This guideline will be accompanied by a set of companion documents to assist the practitioner in applying the guideline. A toolkit will contain materials such as the Medical Nutrition Therapy protocol, documentation forms, outcomes management tools, client education resources and case studies. The toolkit is currently under development and will undergo pilot-testing through the ADA's Dietetic Practice-Based Research Network prior to publication.

Revision

The literature search will be repeated for each guideline topic on an annual basis to identify new research that has been published since the previous search was completed. Based on the quantity and quality of new research, a determination will be made about whether the new information could change the published recommendation or rating.

If a revision is unwarranted, then the search is recorded, dated and saved until the next review and no further action is taken. If the determination is that there could be a change in the recommendation or rating, then the supporting evidence analysis question(s) will be re-analyzed following the standard ADA Evidence Analysis Process (see ADA Evidence Analysis Manual).

When the analysis is completed, the expert workgroup will approve and re-grade the conclusion statements and recommendations. The guideline will undergo a complete revision every three to five years.

Medical Nutrition Therapy and HIV/AIDS

Scientific evidence supports the effectiveness of medical nutrition therapy to increase effectiveness of therapy for HIV/AIDS. Topics included in this guideline are:
  • Medical nutrition therapy and dietitian intervention
  • Caloric needs
  • Macronutrient composition
  • Vitamin and mineral supplementation
  • Treatment of hyperlipidemia
  • Treatment of diarrhea/malabsorption
  • Education on food and water safety
  • Physical activity
The Registered Dietitian plays an integral role on the interdisciplinary care team by determining the optimal nutrition prescription and developing the nutrition care plan for patients undergoing therapy for HIV/AIDS. Based on the patient’s treatment plan and comorbid conditions, other nutrition practice guidelines, such as critical care guidelines,  may be needed in order to provide optimal treatment.     
 
Populations to Whom This Guideline May Apply

This guideline applies to individuals with HIV/AIDS.

Other Guideline Overview Material

For more details on the guideline components, click on the following in the Introduction tab:

  • Scope of Guideline
  • Statement of Intent
  • Guideline Methods
  • Implementation of the Guideline
  • Benefits and Harms of Implementing the Recommendations

Contraindications

Clinical judgment is crucial in the application of these guidelines.  Careful consideration should be given to the application of these guidelines for patients with significant medical co-morbidities.