April/May 2013
Preparing for research. In recognition of the awareness day, community activities and events are being held around the country.
M
ay 18th is HIV Vaccine Awareness Day, an annual observance day conducted by the National Institute of Allergy and Infectious Diseases (NIAID). It recognizes and thanks volunteers, community members, health professionals, and scientists working together to find a safe and effective HIV vaccine. The campaign provides an opportunity to educate communities about the importance of preventive HIV vaccine
Several NIAID-sponsored HIV vaccine clinical trials are underway, but ongoing collaboration is critical for the discovery, development, and implementation of new prevention tools, including an HIV vaccine. Results of recent trials and studies have been promising in the quest. For more information about HIV vaccine research and other ways that you can support these efforts, go to http://bethegeneration.nih.gov.
Source: National Institute of Allergy and Infectious Diseases (www.niaid.nih.gov/news/events/hvad/Pages/default.aspx).
Living Well With
Rheumatic Disease M
any people living with HIV also have rheumatic diseases like arthritis and osteo porosis. These conditions cause joint pain, muscle pain, weakness, and fatigue. Rheumatic diseases can result from HIV infection, medications to control HIV, and other viruses or bacteria. Rheumatic diseases related to HIV can affect any age group but are most common between the ages of 20 and 40. They can affect both men and women and all ethnic groups equally. Painful joints and muscles are often the first and most common complaints of an HIV-associated rheumatic disease. Once diagnosed, most HIV-related rheumatic diseases get better with anti retroviral therapy. Fewer people with HIV are getting rheumatic diseases, and those who do usually have less serious disease.
Relieve the Pain
Most people with HIV who have muscle and joint complaints respond well to standard treatment. This involves a mix of pain relievers and anti-inflammatory drugs that are intended to decrease swelling, pain, and fever. Those who don’t respond to standard treatment may need drugs to suppress the immune system. Physical therapy to relieve symptoms, prevent joint deformities, and preserve function may help too.
Lower Your Risk Some of the things that raise risks for getting HIV also raise the risk for HIV-related rheumatic disease. To lower your risk for both, use safe sex practices. If you have HIV, take your medicines as your doctor has prescribed. Besides taking HIV drugs, eating a well-balanced diet and exercising are other ways for people with HIV to stay healthy and prevent rheumatic diseases. If you get joint pain or muscle weakness while taking HIV drugs, review your medicines with your doctor. Don’t be afraid to ask if any of your medications might be causing your symptoms and if you can switch to another drug. Source: American College of Rheumatology (www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/HIV.asp).
Learning About
MAC Disease
M
ycobacterium avium complex, or “MAC” disease, is the name of a group of germs that can infect people living with HIV. Adults with HIV usually don’t get MAC until their T-cell count drops below 50. Symptoms include fever, night sweats, weight loss, abdominal pain, tiredness, and diarrhea. Laboratory tests can help identify MAC in samples of blood, bone marrow, or tissue. People can get MAC through normal contact with air, food, and water, but it doesn’t spread from one person to another. MAC germs are easy to find in food, water, and soil, making it tough to avoid them. There are drugs, however, that can prevent these germs from causing diseases, including clarithromycin, azithromycin, and rifabutin.
Feature:
Taking Aim at
Wasting Syndrome
Ask your doctor if you should take one of these drugs. If you’ve had MAC disease, continue taking the drugs to treat and prevent further disease. Source: CDC (www.cdc.gov/hiv/resources/brochures/mac.htm).
Visit patientedu.org/mac to read our brochure, “You Can Prevent The editorial content for this brochure developed and createdDisease” solely CMVwas Infection & MAC by the Patient Education Center. The content does not necessarily online orofdownload represent the opinions and/or views our advertisers.a PDF. Healthy Living With HIV is published by the Patient Education Center. Offices: 5 Commerce Way, Suite 202, Hamilton, NJ 08691; and 180 Mount Airy Road, Suite 102, Basking Ridge, NJ 07920. Reproduction without written permission from the publisher is prohibited. Publication of an advertisement or other product mention in Healthy Living With HIV should not be construed as an endorsement of the product or the manufacturer’s claims. Such advertising or product mentions should similarly not be construed as either influencing or controlling the editorial content of Healthy Living With HIV. The appearance of or reference to any person or entity in the editorial material (including photographs) in this brochure does not constitute an expressed or implied endorsement of the product advertised. Readers are encouraged to contact the product manufacturer with any questions about the features and/ or limitations of any product mentioned. The reader also is advised to consult appropriate medical literature and the product information currently provided by the manufacturer of each drug to verify indications, dosage, method, duration of administration, and contraindications. Copyright 2013, Patient Education Center
PEC-HL-APR-044
Also in this issue:
Learning About MAC Disease Preparing for HIV Vaccine Awareness Day Living Well With Rheumatic Disease
Visit us online at www.patientedu.org/hiv
April/May 2013
Preparing for research. In recognition of the awareness day, community activities and events are being held around the country.
M
ay 18th is HIV Vaccine Awareness Day, an annual observance day conducted by the National Institute of Allergy and Infectious Diseases (NIAID). It recognizes and thanks volunteers, community members, health professionals, and scientists working together to find a safe and effective HIV vaccine. The campaign provides an opportunity to educate communities about the importance of preventive HIV vaccine
Several NIAID-sponsored HIV vaccine clinical trials are underway, but ongoing collaboration is critical for the discovery, development, and implementation of new prevention tools, including an HIV vaccine. Results of recent trials and studies have been promising in the quest. For more information about HIV vaccine research and other ways that you can support these efforts, go to http://bethegeneration.nih.gov.
Source: National Institute of Allergy and Infectious Diseases (www.niaid.nih.gov/news/events/hvad/Pages/default.aspx).
Living Well With
Rheumatic Disease M
any people living with HIV also have rheumatic diseases like arthritis and osteo porosis. These conditions cause joint pain, muscle pain, weakness, and fatigue. Rheumatic diseases can result from HIV infection, medications to control HIV, and other viruses or bacteria. Rheumatic diseases related to HIV can affect any age group but are most common between the ages of 20 and 40. They can affect both men and women and all ethnic groups equally. Painful joints and muscles are often the first and most common complaints of an HIV-associated rheumatic disease. Once diagnosed, most HIV-related rheumatic diseases get better with anti retroviral therapy. Fewer people with HIV are getting rheumatic diseases, and those who do usually have less serious disease.
Relieve the Pain
Most people with HIV who have muscle and joint complaints respond well to standard treatment. This involves a mix of pain relievers and anti-inflammatory drugs that are intended to decrease swelling, pain, and fever. Those who don’t respond to standard treatment may need drugs to suppress the immune system. Physical therapy to relieve symptoms, prevent joint deformities, and preserve function may help too.
Lower Your Risk Some of the things that raise risks for getting HIV also raise the risk for HIV-related rheumatic disease. To lower your risk for both, use safe sex practices. If you have HIV, take your medicines as your doctor has prescribed. Besides taking HIV drugs, eating a well-balanced diet and exercising are other ways for people with HIV to stay healthy and prevent rheumatic diseases. If you get joint pain or muscle weakness while taking HIV drugs, review your medicines with your doctor. Don’t be afraid to ask if any of your medications might be causing your symptoms and if you can switch to another drug. Source: American College of Rheumatology (www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/HIV.asp).
Learning About
MAC Disease
M
ycobacterium avium complex, or “MAC” disease, is the name of a group of germs that can infect people living with HIV. Adults with HIV usually don’t get MAC until their T-cell count drops below 50. Symptoms include fever, night sweats, weight loss, abdominal pain, tiredness, and diarrhea. Laboratory tests can help identify MAC in samples of blood, bone marrow, or tissue. People can get MAC through normal contact with air, food, and water, but it doesn’t spread from one person to another. MAC germs are easy to find in food, water, and soil, making it tough to avoid them. There are drugs, however, that can prevent these germs from causing diseases, including clarithromycin, azithromycin, and rifabutin.
Feature:
Taking Aim at
Wasting Syndrome
Ask your doctor if you should take one of these drugs. If you’ve had MAC disease, continue taking the drugs to treat and prevent further disease. Source: CDC (www.cdc.gov/hiv/resources/brochures/mac.htm).
Visit patientedu.org/mac to read our brochure, “You Can Prevent The editorial content for this brochure developed and createdDisease” solely CMVwas Infection & MAC by the Patient Education Center. The content does not necessarily online orofdownload represent the opinions and/or views our advertisers.a PDF. Healthy Living With HIV is published by the Patient Education Center. Offices: 5 Commerce Way, Suite 202, Hamilton, NJ 08691; and 180 Mount Airy Road, Suite 102, Basking Ridge, NJ 07920. Reproduction without written permission from the publisher is prohibited. Publication of an advertisement or other product mention in Healthy Living With HIV should not be construed as an endorsement of the product or the manufacturer’s claims. Such advertising or product mentions should similarly not be construed as either influencing or controlling the editorial content of Healthy Living With HIV. The appearance of or reference to any person or entity in the editorial material (including photographs) in this brochure does not constitute an expressed or implied endorsement of the product advertised. Readers are encouraged to contact the product manufacturer with any questions about the features and/ or limitations of any product mentioned. The reader also is advised to consult appropriate medical literature and the product information currently provided by the manufacturer of each drug to verify indications, dosage, method, duration of administration, and contraindications. Copyright 2013, Patient Education Center
PEC-HL-APR-044
Also in this issue:
Learning About MAC Disease Preparing for HIV Vaccine Awareness Day Living Well With Rheumatic Disease
Visit us online at www.patientedu.org/hiv
April/May 2013
Preparing for research. In recognition of the awareness day, community activities and events are being held around the country.
M
ay 18th is HIV Vaccine Awareness Day, an annual observance day conducted by the National Institute of Allergy and Infectious Diseases (NIAID). It recognizes and thanks volunteers, community members, health professionals, and scientists working together to find a safe and effective HIV vaccine. The campaign provides an opportunity to educate communities about the importance of preventive HIV vaccine
Several NIAID-sponsored HIV vaccine clinical trials are underway, but ongoing collaboration is critical for the discovery, development, and implementation of new prevention tools, including an HIV vaccine. Results of recent trials and studies have been promising in the quest. For more information about HIV vaccine research and other ways that you can support these efforts, go to http://bethegeneration.nih.gov.
Source: National Institute of Allergy and Infectious Diseases (www.niaid.nih.gov/news/events/hvad/Pages/default.aspx).
Living Well With
Rheumatic Disease M
any people living with HIV also have rheumatic diseases like arthritis and osteo porosis. These conditions cause joint pain, muscle pain, weakness, and fatigue. Rheumatic diseases can result from HIV infection, medications to control HIV, and other viruses or bacteria. Rheumatic diseases related to HIV can affect any age group but are most common between the ages of 20 and 40. They can affect both men and women and all ethnic groups equally. Painful joints and muscles are often the first and most common complaints of an HIV-associated rheumatic disease. Once diagnosed, most HIV-related rheumatic diseases get better with anti retroviral therapy. Fewer people with HIV are getting rheumatic diseases, and those who do usually have less serious disease.
Relieve the Pain
Most people with HIV who have muscle and joint complaints respond well to standard treatment. This involves a mix of pain relievers and anti-inflammatory drugs that are intended to decrease swelling, pain, and fever. Those who don’t respond to standard treatment may need drugs to suppress the immune system. Physical therapy to relieve symptoms, prevent joint deformities, and preserve function may help too.
Lower Your Risk Some of the things that raise risks for getting HIV also raise the risk for HIV-related rheumatic disease. To lower your risk for both, use safe sex practices. If you have HIV, take your medicines as your doctor has prescribed. Besides taking HIV drugs, eating a well-balanced diet and exercising are other ways for people with HIV to stay healthy and prevent rheumatic diseases. If you get joint pain or muscle weakness while taking HIV drugs, review your medicines with your doctor. Don’t be afraid to ask if any of your medications might be causing your symptoms and if you can switch to another drug. Source: American College of Rheumatology (www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/HIV.asp).
Learning About
MAC Disease
M
ycobacterium avium complex, or “MAC” disease, is the name of a group of germs that can infect people living with HIV. Adults with HIV usually don’t get MAC until their T-cell count drops below 50. Symptoms include fever, night sweats, weight loss, abdominal pain, tiredness, and diarrhea. Laboratory tests can help identify MAC in samples of blood, bone marrow, or tissue. People can get MAC through normal contact with air, food, and water, but it doesn’t spread from one person to another. MAC germs are easy to find in food, water, and soil, making it tough to avoid them. There are drugs, however, that can prevent these germs from causing diseases, including clarithromycin, azithromycin, and rifabutin.
Feature:
Taking Aim at
Wasting Syndrome
Ask your doctor if you should take one of these drugs. If you’ve had MAC disease, continue taking the drugs to treat and prevent further disease. Source: CDC (www.cdc.gov/hiv/resources/brochures/mac.htm).
Visit patientedu.org/mac to read our brochure, “You Can Prevent The editorial content for this brochure developed and createdDisease” solely CMVwas Infection & MAC by the Patient Education Center. The content does not necessarily online orofdownload represent the opinions and/or views our advertisers.a PDF. Healthy Living With HIV is published by the Patient Education Center. Offices: 5 Commerce Way, Suite 202, Hamilton, NJ 08691; and 180 Mount Airy Road, Suite 102, Basking Ridge, NJ 07920. Reproduction without written permission from the publisher is prohibited. Publication of an advertisement or other product mention in Healthy Living With HIV should not be construed as an endorsement of the product or the manufacturer’s claims. Such advertising or product mentions should similarly not be construed as either influencing or controlling the editorial content of Healthy Living With HIV. The appearance of or reference to any person or entity in the editorial material (including photographs) in this brochure does not constitute an expressed or implied endorsement of the product advertised. Readers are encouraged to contact the product manufacturer with any questions about the features and/ or limitations of any product mentioned. The reader also is advised to consult appropriate medical literature and the product information currently provided by the manufacturer of each drug to verify indications, dosage, method, duration of administration, and contraindications. Copyright 2013, Patient Education Center
PEC-HL-APR-044
Also in this issue:
Learning About MAC Disease Preparing for HIV Vaccine Awareness Day Living Well With Rheumatic Disease
Visit us online at www.patientedu.org/hiv
Taking Aim at
Wasting Syndrome When involuntary weight loss occurs, it might be a sign of wasting syndrome. Various treatments are being tested, but it’s important for people with HIV/AIDS to take their drug regimens as prescribed as well as monitor their weight, eat healthy, and keep an eye out in case warning signs appear. What Is Wasting Syndrome?
A Look at the Causes
asting syndrome is the involuntary loss of more than 10% of body weight plus having more than 30 days of diarrhea, weakness, and/or fever. In scientific studies, wasting has been linked to faster disease progression and quicker death. In fact, losing just 5% of body weight can have the same negative effects.
Several factors can contribute to wasting syndrome. These include low food intake, poor absorption of nutrients, and changes in your metabolism (see Table). Unfortunately, these factors can work together to create a “downward spiral” in which other problems come up or get worse. This can further reduce your appetite and make you less able to shop for or cook meals. Eating less can accelerate some of the other problems that have been linked to HIV/AIDS.
W
The incidence of wasting syndrome has decreased dramatically since 1996, but it’s still a problem for people living with AIDS. Importantly, wasting can be problematic even for people whose HIV is controlled by medications. Part of the weight lost during wasting is fat, while the other weight loss might be the result of losing muscle mass. This change in lean body mass may be more serious for people with HIV/AIDS. If you’re unsure about your muscle or fat levels, there are simple and painless office procedures that can help. Talk to your healthcare provider to see if you should undergo any of these tests.
Treat Symptoms to Manage Wasting Syndrome Although there is no standard treatment for wasting syndrome, the good news is that people who maintain successful treatment of their HIV with their medications can improve their chances of avoiding wasting. Consistent use of anti-HIV medications usually leads to healthy weight gain. By sticking to your treatment regimen, you’re less likely to develop wasting. Decreasing your viral load to undetectable levels has been shown to lead to an increased weight gain of 10% to 25% in a year. Another way to deal with wasting syndrome is to work with your healthcare provider to treat each of the causes of it. Reducing nausea and vomiting can help increase food intake. Appetite stimulants have emerged on the market, and other medications are available to fight nausea. Your healthcare provider can work with you to determine which treatments may work best for you.
Treating diarrhea and opportunistic infections in the intestines helps when your body is poorly absorbing nutrients. In recent years, there has been a lot of progress in this area. However, two parasitic infections—crypto sporidiosis and microsporidiosis—are still very difficult to treat. That said, the use of nutritional supplements can help with many nutrient absorption problems. Products have been specifically designed to provide easy-to-absorb nutrients. Other nutritional supplements can increase weight. Talk to your health care provider before starting any supplements. They are intended for use only as an addition to a balanced diet. Treating changes in metabolism is a little more challenging. Hormone treatments are still being investigated in clinical studies. While some therapies have been shown to increase weight and lean body mass, others have helped to decrease fat. These treatments, however, can be extremely expensive, and
Table
researchers aren’t completely sure of their potential for causing side effects. Exercise training using weights and machines can also be of benefit. In addition to being less expensive, exercise can improve mood and cholesterol levels while strengthening bone. Be sure to work with your healthcare provider to determine the best way for you to start exercise training. Source: AIDSInfoNet.org (http://aidsinfonet.org/fact_sheets/view/519?lang=eng).
Common Causes of AIDS Wasting Syndrome
Considerations With Poor Nutrient Absorption:
Considerations With Low Food Intake:
• In HIV, several infections and parasites can interfere with the absorption of nutrients through the small intestine.
• Poor appetite can result from drug side effects, such as: - Nausea. - Changes in taste. - Tingling around the mouth.
• HIV may directly affect the intestinal lining and reduce nutrient absorption. • Diarrhea causes loss of calories and nutrients. Considerations With Altered Metabolism: • Food processing and protein building are affected by HIV. Before symptoms show up, more energy is needed.
• Some drugs must be taken with an empty stomach, while others require taking them with a meal. • Opportunistic infections in the mouth or throat can make it painful to eat.
• Increased activity of the immune system may alter metabolism.
• Infections in the gut can make people feel full after eating just a little food.
• People with HIV need more calories just to maintain their body weight.
• Depression can lower appetite.
• Hormone levels and cytokines should be monitored because they can affect the metabolism.
• Lack of money or energy can make it difficult to shop for food or prepare meals. Source: AIDSInfoNet.org (http://aidsinfonet.org/fact_sheets/view/519?lang=eng).
Taking Aim at
Wasting Syndrome When involuntary weight loss occurs, it might be a sign of wasting syndrome. Various treatments are being tested, but it’s important for people with HIV/AIDS to take their drug regimens as prescribed as well as monitor their weight, eat healthy, and keep an eye out in case warning signs appear. What Is Wasting Syndrome?
A Look at the Causes
asting syndrome is the involuntary loss of more than 10% of body weight plus having more than 30 days of diarrhea, weakness, and/or fever. In scientific studies, wasting has been linked to faster disease progression and quicker death. In fact, losing just 5% of body weight can have the same negative effects.
Several factors can contribute to wasting syndrome. These include low food intake, poor absorption of nutrients, and changes in your metabolism (see Table). Unfortunately, these factors can work together to create a “downward spiral” in which other problems come up or get worse. This can further reduce your appetite and make you less able to shop for or cook meals. Eating less can accelerate some of the other problems that have been linked to HIV/AIDS.
W
The incidence of wasting syndrome has decreased dramatically since 1996, but it’s still a problem for people living with AIDS. Importantly, wasting can be problematic even for people whose HIV is controlled by medications. Part of the weight lost during wasting is fat, while the other weight loss might be the result of losing muscle mass. This change in lean body mass may be more serious for people with HIV/AIDS. If you’re unsure about your muscle or fat levels, there are simple and painless office procedures that can help. Talk to your healthcare provider to see if you should undergo any of these tests.
Treat Symptoms to Manage Wasting Syndrome Although there is no standard treatment for wasting syndrome, the good news is that people who maintain successful treatment of their HIV with their medications can improve their chances of avoiding wasting. Consistent use of anti-HIV medications usually leads to healthy weight gain. By sticking to your treatment regimen, you’re less likely to develop wasting. Decreasing your viral load to undetectable levels has been shown to lead to an increased weight gain of 10% to 25% in a year. Another way to deal with wasting syndrome is to work with your healthcare provider to treat each of the causes of it. Reducing nausea and vomiting can help increase food intake. Appetite stimulants have emerged on the market, and other medications are available to fight nausea. Your healthcare provider can work with you to determine which treatments may work best for you.
Treating diarrhea and opportunistic infections in the intestines helps when your body is poorly absorbing nutrients. In recent years, there has been a lot of progress in this area. However, two parasitic infections—crypto sporidiosis and microsporidiosis—are still very difficult to treat. That said, the use of nutritional supplements can help with many nutrient absorption problems. Products have been specifically designed to provide easy-to-absorb nutrients. Other nutritional supplements can increase weight. Talk to your health care provider before starting any supplements. They are intended for use only as an addition to a balanced diet. Treating changes in metabolism is a little more challenging. Hormone treatments are still being investigated in clinical studies. While some therapies have been shown to increase weight and lean body mass, others have helped to decrease fat. These treatments, however, can be extremely expensive, and
Table
researchers aren’t completely sure of their potential for causing side effects. Exercise training using weights and machines can also be of benefit. In addition to being less expensive, exercise can improve mood and cholesterol levels while strengthening bone. Be sure to work with your healthcare provider to determine the best way for you to start exercise training. Source: AIDSInfoNet.org (http://aidsinfonet.org/fact_sheets/view/519?lang=eng).
Common Causes of AIDS Wasting Syndrome
Considerations With Poor Nutrient Absorption:
Considerations With Low Food Intake:
• In HIV, several infections and parasites can interfere with the absorption of nutrients through the small intestine.
• Poor appetite can result from drug side effects, such as: - Nausea. - Changes in taste. - Tingling around the mouth.
• HIV may directly affect the intestinal lining and reduce nutrient absorption. • Diarrhea causes loss of calories and nutrients. Considerations With Altered Metabolism: • Food processing and protein building are affected by HIV. Before symptoms show up, more energy is needed.
• Some drugs must be taken with an empty stomach, while others require taking them with a meal. • Opportunistic infections in the mouth or throat can make it painful to eat.
• Increased activity of the immune system may alter metabolism.
• Infections in the gut can make people feel full after eating just a little food.
• People with HIV need more calories just to maintain their body weight.
• Depression can lower appetite.
• Hormone levels and cytokines should be monitored because they can affect the metabolism.
• Lack of money or energy can make it difficult to shop for food or prepare meals. Source: AIDSInfoNet.org (http://aidsinfonet.org/fact_sheets/view/519?lang=eng).
Taking Aim at
Wasting Syndrome When involuntary weight loss occurs, it might be a sign of wasting syndrome. Various treatments are being tested, but it’s important for people with HIV/AIDS to take their drug regimens as prescribed as well as monitor their weight, eat healthy, and keep an eye out in case warning signs appear. What Is Wasting Syndrome?
A Look at the Causes
asting syndrome is the involuntary loss of more than 10% of body weight plus having more than 30 days of diarrhea, weakness, and/or fever. In scientific studies, wasting has been linked to faster disease progression and quicker death. In fact, losing just 5% of body weight can have the same negative effects.
Several factors can contribute to wasting syndrome. These include low food intake, poor absorption of nutrients, and changes in your metabolism (see Table). Unfortunately, these factors can work together to create a “downward spiral” in which other problems come up or get worse. This can further reduce your appetite and make you less able to shop for or cook meals. Eating less can accelerate some of the other problems that have been linked to HIV/AIDS.
W
The incidence of wasting syndrome has decreased dramatically since 1996, but it’s still a problem for people living with AIDS. Importantly, wasting can be problematic even for people whose HIV is controlled by medications. Part of the weight lost during wasting is fat, while the other weight loss might be the result of losing muscle mass. This change in lean body mass may be more serious for people with HIV/AIDS. If you’re unsure about your muscle or fat levels, there are simple and painless office procedures that can help. Talk to your healthcare provider to see if you should undergo any of these tests.
Treat Symptoms to Manage Wasting Syndrome Although there is no standard treatment for wasting syndrome, the good news is that people who maintain successful treatment of their HIV with their medications can improve their chances of avoiding wasting. Consistent use of anti-HIV medications usually leads to healthy weight gain. By sticking to your treatment regimen, you’re less likely to develop wasting. Decreasing your viral load to undetectable levels has been shown to lead to an increased weight gain of 10% to 25% in a year. Another way to deal with wasting syndrome is to work with your healthcare provider to treat each of the causes of it. Reducing nausea and vomiting can help increase food intake. Appetite stimulants have emerged on the market, and other medications are available to fight nausea. Your healthcare provider can work with you to determine which treatments may work best for you.
Treating diarrhea and opportunistic infections in the intestines helps when your body is poorly absorbing nutrients. In recent years, there has been a lot of progress in this area. However, two parasitic infections—crypto sporidiosis and microsporidiosis—are still very difficult to treat. That said, the use of nutritional supplements can help with many nutrient absorption problems. Products have been specifically designed to provide easy-to-absorb nutrients. Other nutritional supplements can increase weight. Talk to your health care provider before starting any supplements. They are intended for use only as an addition to a balanced diet. Treating changes in metabolism is a little more challenging. Hormone treatments are still being investigated in clinical studies. While some therapies have been shown to increase weight and lean body mass, others have helped to decrease fat. These treatments, however, can be extremely expensive, and
Table
researchers aren’t completely sure of their potential for causing side effects. Exercise training using weights and machines can also be of benefit. In addition to being less expensive, exercise can improve mood and cholesterol levels while strengthening bone. Be sure to work with your healthcare provider to determine the best way for you to start exercise training. Source: AIDSInfoNet.org (http://aidsinfonet.org/fact_sheets/view/519?lang=eng).
Common Causes of AIDS Wasting Syndrome
Considerations With Poor Nutrient Absorption:
Considerations With Low Food Intake:
• In HIV, several infections and parasites can interfere with the absorption of nutrients through the small intestine.
• Poor appetite can result from drug side effects, such as: - Nausea. - Changes in taste. - Tingling around the mouth.
• HIV may directly affect the intestinal lining and reduce nutrient absorption. • Diarrhea causes loss of calories and nutrients. Considerations With Altered Metabolism: • Food processing and protein building are affected by HIV. Before symptoms show up, more energy is needed.
• Some drugs must be taken with an empty stomach, while others require taking them with a meal. • Opportunistic infections in the mouth or throat can make it painful to eat.
• Increased activity of the immune system may alter metabolism.
• Infections in the gut can make people feel full after eating just a little food.
• People with HIV need more calories just to maintain their body weight.
• Depression can lower appetite.
• Hormone levels and cytokines should be monitored because they can affect the metabolism.
• Lack of money or energy can make it difficult to shop for food or prepare meals. Source: AIDSInfoNet.org (http://aidsinfonet.org/fact_sheets/view/519?lang=eng).
Taking Aim at
Wasting Syndrome When involuntary weight loss occurs, it might be a sign of wasting syndrome. Various treatments are being tested, but it’s important for people with HIV/AIDS to take their drug regimens as prescribed as well as monitor their weight, eat healthy, and keep an eye out in case warning signs appear. What Is Wasting Syndrome?
A Look at the Causes
asting syndrome is the involuntary loss of more than 10% of body weight plus having more than 30 days of diarrhea, weakness, and/or fever. In scientific studies, wasting has been linked to faster disease progression and quicker death. In fact, losing just 5% of body weight can have the same negative effects.
Several factors can contribute to wasting syndrome. These include low food intake, poor absorption of nutrients, and changes in your metabolism (see Table). Unfortunately, these factors can work together to create a “downward spiral” in which other problems come up or get worse. This can further reduce your appetite and make you less able to shop for or cook meals. Eating less can accelerate some of the other problems that have been linked to HIV/AIDS.
W
The incidence of wasting syndrome has decreased dramatically since 1996, but it’s still a problem for people living with AIDS. Importantly, wasting can be problematic even for people whose HIV is controlled by medications. Part of the weight lost during wasting is fat, while the other weight loss might be the result of losing muscle mass. This change in lean body mass may be more serious for people with HIV/AIDS. If you’re unsure about your muscle or fat levels, there are simple and painless office procedures that can help. Talk to your healthcare provider to see if you should undergo any of these tests.
Treat Symptoms to Manage Wasting Syndrome Although there is no standard treatment for wasting syndrome, the good news is that people who maintain successful treatment of their HIV with their medications can improve their chances of avoiding wasting. Consistent use of anti-HIV medications usually leads to healthy weight gain. By sticking to your treatment regimen, you’re less likely to develop wasting. Decreasing your viral load to undetectable levels has been shown to lead to an increased weight gain of 10% to 25% in a year. Another way to deal with wasting syndrome is to work with your healthcare provider to treat each of the causes of it. Reducing nausea and vomiting can help increase food intake. Appetite stimulants have emerged on the market, and other medications are available to fight nausea. Your healthcare provider can work with you to determine which treatments may work best for you.
Treating diarrhea and opportunistic infections in the intestines helps when your body is poorly absorbing nutrients. In recent years, there has been a lot of progress in this area. However, two parasitic infections—crypto sporidiosis and microsporidiosis—are still very difficult to treat. That said, the use of nutritional supplements can help with many nutrient absorption problems. Products have been specifically designed to provide easy-to-absorb nutrients. Other nutritional supplements can increase weight. Talk to your health care provider before starting any supplements. They are intended for use only as an addition to a balanced diet. Treating changes in metabolism is a little more challenging. Hormone treatments are still being investigated in clinical studies. While some therapies have been shown to increase weight and lean body mass, others have helped to decrease fat. These treatments, however, can be extremely expensive, and
Table
researchers aren’t completely sure of their potential for causing side effects. Exercise training using weights and machines can also be of benefit. In addition to being less expensive, exercise can improve mood and cholesterol levels while strengthening bone. Be sure to work with your healthcare provider to determine the best way for you to start exercise training. Source: AIDSInfoNet.org (http://aidsinfonet.org/fact_sheets/view/519?lang=eng).
Common Causes of AIDS Wasting Syndrome
Considerations With Poor Nutrient Absorption:
Considerations With Low Food Intake:
• In HIV, several infections and parasites can interfere with the absorption of nutrients through the small intestine.
• Poor appetite can result from drug side effects, such as: - Nausea. - Changes in taste. - Tingling around the mouth.
• HIV may directly affect the intestinal lining and reduce nutrient absorption. • Diarrhea causes loss of calories and nutrients. Considerations With Altered Metabolism: • Food processing and protein building are affected by HIV. Before symptoms show up, more energy is needed.
• Some drugs must be taken with an empty stomach, while others require taking them with a meal. • Opportunistic infections in the mouth or throat can make it painful to eat.
• Increased activity of the immune system may alter metabolism.
• Infections in the gut can make people feel full after eating just a little food.
• People with HIV need more calories just to maintain their body weight.
• Depression can lower appetite.
• Hormone levels and cytokines should be monitored because they can affect the metabolism.
• Lack of money or energy can make it difficult to shop for food or prepare meals. Source: AIDSInfoNet.org (http://aidsinfonet.org/fact_sheets/view/519?lang=eng).
April/May 2013
Preparing for research. In recognition of the awareness day, community activities and events are being held around the country.
M
ay 18th is HIV Vaccine Awareness Day, an annual observance day conducted by the National Institute of Allergy and Infectious Diseases (NIAID). It recognizes and thanks volunteers, community members, health professionals, and scientists working together to find a safe and effective HIV vaccine. The campaign provides an opportunity to educate communities about the importance of preventive HIV vaccine
Several NIAID-sponsored HIV vaccine clinical trials are underway, but ongoing collaboration is critical for the discovery, development, and implementation of new prevention tools, including an HIV vaccine. Results of recent trials and studies have been promising in the quest. For more information about HIV vaccine research and other ways that you can support these efforts, go to http://bethegeneration.nih.gov.
Source: National Institute of Allergy and Infectious Diseases (www.niaid.nih.gov/news/events/hvad/Pages/default.aspx).
Living Well With
Rheumatic Disease M
any people living with HIV also have rheumatic diseases like arthritis and osteo porosis. These conditions cause joint pain, muscle pain, weakness, and fatigue. Rheumatic diseases can result from HIV infection, medications to control HIV, and other viruses or bacteria. Rheumatic diseases related to HIV can affect any age group but are most common between the ages of 20 and 40. They can affect both men and women and all ethnic groups equally. Painful joints and muscles are often the first and most common complaints of an HIV-associated rheumatic disease. Once diagnosed, most HIV-related rheumatic diseases get better with anti retroviral therapy. Fewer people with HIV are getting rheumatic diseases, and those who do usually have less serious disease.
Relieve the Pain
Most people with HIV who have muscle and joint complaints respond well to standard treatment. This involves a mix of pain relievers and anti-inflammatory drugs that are intended to decrease swelling, pain, and fever. Those who don’t respond to standard treatment may need drugs to suppress the immune system. Physical therapy to relieve symptoms, prevent joint deformities, and preserve function may help too.
Lower Your Risk Some of the things that raise risks for getting HIV also raise the risk for HIV-related rheumatic disease. To lower your risk for both, use safe sex practices. If you have HIV, take your medicines as your doctor has prescribed. Besides taking HIV drugs, eating a well-balanced diet and exercising are other ways for people with HIV to stay healthy and prevent rheumatic diseases. If you get joint pain or muscle weakness while taking HIV drugs, review your medicines with your doctor. Don’t be afraid to ask if any of your medications might be causing your symptoms and if you can switch to another drug. Source: American College of Rheumatology (www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/HIV.asp).
Learning About
MAC Disease
M
ycobacterium avium complex, or “MAC” disease, is the name of a group of germs that can infect people living with HIV. Adults with HIV usually don’t get MAC until their T-cell count drops below 50. Symptoms include fever, night sweats, weight loss, abdominal pain, tiredness, and diarrhea. Laboratory tests can help identify MAC in samples of blood, bone marrow, or tissue. People can get MAC through normal contact with air, food, and water, but it doesn’t spread from one person to another. MAC germs are easy to find in food, water, and soil, making it tough to avoid them. There are drugs, however, that can prevent these germs from causing diseases, including clarithromycin, azithromycin, and rifabutin.
Feature:
Taking Aim at
Wasting Syndrome
Ask your doctor if you should take one of these drugs. If you’ve had MAC disease, continue taking the drugs to treat and prevent further disease. Source: CDC (www.cdc.gov/hiv/resources/brochures/mac.htm).
Visit patientedu.org/mac to read our brochure, “You Can Prevent The editorial content for this brochure developed and createdDisease” solely CMVwas Infection & MAC by the Patient Education Center. The content does not necessarily online orofdownload represent the opinions and/or views our advertisers.a PDF. Healthy Living With HIV is published by the Patient Education Center. Offices: 5 Commerce Way, Suite 202, Hamilton, NJ 08691; and 180 Mount Airy Road, Suite 102, Basking Ridge, NJ 07920. Reproduction without written permission from the publisher is prohibited. Publication of an advertisement or other product mention in Healthy Living With HIV should not be construed as an endorsement of the product or the manufacturer’s claims. Such advertising or product mentions should similarly not be construed as either influencing or controlling the editorial content of Healthy Living With HIV. The appearance of or reference to any person or entity in the editorial material (including photographs) in this brochure does not constitute an expressed or implied endorsement of the product advertised. Readers are encouraged to contact the product manufacturer with any questions about the features and/ or limitations of any product mentioned. The reader also is advised to consult appropriate medical literature and the product information currently provided by the manufacturer of each drug to verify indications, dosage, method, duration of administration, and contraindications. Copyright 2013, Patient Education Center
PEC-HL-APR-044
Also in this issue:
Learning About MAC Disease Preparing for HIV Vaccine Awareness Day Living Well With Rheumatic Disease
Visit us online at www.patientedu.org/hiv