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HIV NUTRITION UPDATE
VOLUME 9, ISSUE 3
HIV Nutrition Crisis in New Delhi

 

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 A plethora of non-governmental organizations (NGOs) and activists exist but many of them do precious little by way of actually detecting or treating patients with HIV. A greater compassion for children is apparent but the destruction of existing institutions is also widespread. There is a general feeling that nothing can be done. In India, HIV is a catchy word and a good political slogan that generates funds for NGOs from abroad.
Although the government publicizes its program of distributing free antiretrovirals, the program lacks scientific wisdom. Free distribution of anti-tuberculosis drugs could not succeed for various reasons of logistics including erratic availability of drugs. Tuberculosis (TB) is increasing despite free treatment and medicines. Antiretrovirals are more expensive and need more skilled personnel to administer them so it is unlikely that such a program will be sustainable. It might be better to spend the limited resources available to educate physicians and the general public on both HIV and TB.

Medical & Nutritional Care

The most common opportunistic infection in patients living in India is TB. Unfortunately, most patients receive and take treatment for TB without consideration of a positive HIV status by either the caregiver or the patient. If a patient has elevated liver enzymes, laboratory tests to check hepatitis B surface antigen is often asked for but seldom detected. Rarely, however is an HIV test done on a TB patient.

Chronic diarrhea is another common presentation in New Delhi patients. Usually, it is not possible to identify the culprit organism due to the lack of appropriate laboratory findings. Presumptive use of nitazoxanide or metronidazole seems to give reasonable results.

Most individuals living in India are vegetarian. People living with HIV in New Delhi are generally malnourished and in need of adequate calories and protein intake to replete and maintain lean body mass. Nutritional status is worsened by the co-existence of TB in many cases.
 
 
 

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2/15/2005