Malnutrition is a common component of the clinical syndrome seen in patients with AIDS. Preliminary evidence suggests nutritional status may be associated with gastrointestinal dysfunction and clinical outcome in the AIDS population. Therefore, in this proposal we intend to determine the severity and course of malnutrition and its relationship to overall clinical outcome and the observed immune deficiency in patients with AIDS. A population of 250 patients with AIDS will have three month determinations throughout their entire clinical course of: nutritional status (weight, anthropometrics, body composition studies, dietary intake using 7 Day Food Records): gastrointestinal symptoms (dysphagia, nausea, vomiting, diarrhea, malabsorption); gastrointestinal infections; energy balance (energy expenditure and caloric intake); intercurrent health events; and immune function (Total, CD8 and CD4 T lymphocytes, HIV p24 antigen, and skin test response). These parameters will be correlated with survival as a major study endpoint. The study observations will also be used to correlate changes in nutritional status with the frequency, severity, and outcome for individual infections and malignant complications seen in this AIDS patient population. Two potential therapeutic strategies from malnutrition in AIDS will also be evaluated. A defined program of Dietary Counseling designed to meet any identified nutritional deficiencies in terms of calories and macro-and micro-nutrients will be provided all participants. In addition, the clinical efficacy of the agent, hydrazine sulfate (shown recently to result in albumin and weight maintenance and increased survival in cancer populations) will be evaluated in a phase II trial in a sub-population of 30 AIDS patients with advanced Kaposi's sarcoma. On the basis of this study, we will define the relative importance of alterations in nutritional status and its relationship to gastrointestinal function in determining clinical outcome for the AIDS patient population, and evaluate several strategies for treating patients with AIDS at risk for development of the wasting syndrome.
| Chlebowski, R T; Grosvenor, M; Lillington, L et al. (1995) Dietary intake and counseling, weight maintenance, and the course of HIV infection. J Am Diet Assoc 95:428-32;quiz 433-5 |
| Chlebowski, R T (1991) Nutritional support of the medical oncology patient. Hematol Oncol Clin North Am 5:147-60 |
