Protein Requirements for AIDS Patients
Protica Staff Writer - Wednesday, June 29, 2005
AIDS is a chronic, intractable condition caused by the Human Immunodeficiency Virus (HIV). The virus targets the immune system and ultimately overwhelms it. Given the limitations of current therapy, it is imperative that a holistic approach be implemented, which involves medication, dietary management and stress management.


AIDS is a chronic, intractable condition caused by the Human Immunodeficiency Virus (HIV). The virus targets the immune system and ultimately overwhelms it. Given the limitations of current therapy, it is imperative that a holistic approach be implemented, which involves medication, dietary management and stress management.

Dietary Management for AIDS concentrates on increasing appetite, improving digestion and absorption of nutrients, and preventing catabolism (i.e. breakdown) of proteins in the body. Consequently malnutrition and weight loss can be minimized, which in turn enhances the immune system. Proteins play a vital role for optimal health especially in AIDS as it replenishes cells, tissues and muscles, apart from its biological and immunological functions. Enough medical literature exists to suggest that a high protein diet of casein and whey are recommended. Specific amino acids such as glutamine, methionine, arginine, N-acetyl cysteine (NAC) and hydroxymethyl butyrate (HMB) are essential.

Involuntary body weight loss is a frequent manifestation of HIV infection and ultimately affects the majority of patients. Wasting may not be an inevitable consequence of HIV infection, but may be a consequence of multiple nutritional insults. A variety of etiologies contribute to this wasting, including, hypermetabolism, alterations in metabolism, lessened oral intake, malabsorption, immune mechanisms and endocrine dysfunction. Wasting of the lean body mass is associated with a decreased survival rate. It further impairs immune function. According to studies, a trend was found towards a decrease in body weight and disease progression. Both HIV positive men and women have significantly lower body weight, fat and body cell mass than that of HIV negative controls.

The number of nutrition–related clinical signs and symptoms in each individual correlated with the magnitude of weight loss. A low energy intake, lack of protein in diet and catabolism of proteins from muscle tissues are largely responsible for this avoidable morbidity in immunocompromised patients (Suneeta franklin et al., 1999). Hence it is recommended that a person living with HIV or AIDS consumes between 0.8 g - 1 g of easily digestible and high quality protein per pound of body weight (equivalent to 1.8 -2.2 g body weight (Bristol, 1995). Treating AIDS-related wasting syndrome with a whey protein concentrate (WPC) may combat the negative effect of oxidative stress, improve T-cell function and T-cell survival, as well as aid in the control of HIV replication.

Whey proteins are made up of a-lactalbumin and ß-lactoglobulin (defending against infection) serum albumin, the immune globulin, enzymes and protease -- peptones ß-lactoglobulin accounts for about 50% of total whey proteins. It also contains small amounts of lactoferrin (iron, containing protein having protecting effect) and serum transferrin. Whey protein consists of a group of proteins known to produce a substance (glutathione) that may improve the immune system and also slow the weight loss often experienced by people with AIDS. It is also a diet supplement providing a protein rich energy boost while containing little lactose.
A Partially hydrolyzed whey protein is useful if digestion is difficult. Milk proteins are also easier to digest due to the presence of casein (Metcalfe, 1992). Casein constitute 80% of total nitrogen in milk and is a colloidal protein calcium phosphate complex. It is a good source of essential amino acids (Glutamic acid, proline, aspartic, leucine, lysine and valine) (Srilakshmi, 1996).

Another consideration for proteins is their content of the sulphur-containing amino acids cystine and methionine. People with AIDS have low levels of methionine (Muller, 1996). It causes deterioration that occurs in the nervous system (Revillard, 1992). It is responsible for some aspects of disease process in AIDS (Keating, 1991). Methionine deficiency can also be responsible for symptom such as dementia (Tan, 1998). There are reasons to suspect the HIV myelopathy might be due to a deficiency of the amino acid Methionine (Di Rocco A et al., 1998).

The amino acid N-acetyl cysteine (NAC) has shown to inhibit the replication of HIV (Roederes et al., 1990). NAC, along with glutamine, is required to maintain adequate levels of glutathione (Noyer et al., 1998). Glutamine is needed for the synthesis of glutathione, an important antioxidant within cells that is frequently depleted in people with HIV and AIDS (Robinson et al., 1992).

The combination of glutamine, arginine and amino acid derivative, hydroxy methyl butyrate (HMD), may prevent loss of lean body mass (i.e. wasting) in people with AIDS (Clark et al., 2000).

Thus development of a protein supplement containing casein, whey and amino acid derivative arginine, glutamine, methionine, N-acetyl cysteine and HMB can provide an apt high protein diet for individuals suffering from HIV or AIDS. Change of the attitude with assessment of nutritional status is necessary to slow down the progression of the disease and improve the quality of the life, in the absence of a cure for HIV/AIDS.


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