Malnutrition and concomitant herpesvirus infection as a possible cause of immunodeficiency syndrome in Haitian infants

Acquired immunodeficiency syndrome (AIDS)

The Acquired Immunodeficiency Syndrome (AIDS), caused by the human immunodeficiency virus (HIV), also called the human T-lymphotropic virus type III/lymphadenopathy-associated virus [HTLV-III/LAV], has affected over 23,000 people; more than half of those with the disease have died. The actual case fatality rate approaches 100%. AIDS affects all groups and classes of people, although some are at special risk. Distribution of the disease is worldwide. The illness' effects on the body are widespread; of special interest are the ophthalmologic manifestations. The eye may be infected by various viruses (cytomegalovirus, varicella-zoster virus, herpes simplex virus or HIV itself), toxoplasma gondii, candida sp, cryptococcus neoformans, M. tuberculosis, or M. avium-intracellulare. Kaposi's sarcoma may affect the eye as well. Retinal vascular abnormalities (e.g., cotton-wool spots, vasculitis) are not uncommon in AIDS. The syndrome may present with neuro-ophthalmologic manifestations. No effective treatment for the illness is currently available, although several hold promise and there is hope for an AIDS vaccine. Prevention of infection through reduction of risks appears to be the only defense against AIDS at this time.

Significance of altered nutritional status in acquired immune deficiency syndrome (AIDS)

Severe unrelenting weight loss appears to be a major component of the clinical picture seen in the patients with Acquired Immune Deficiency Syndrome (AIDS). Weight loss has been associated with a poor prognosis for AIDS patients with Kaposi's sarcoma. Strong evidence from a variety of clinical situations indicates that malnutrition per se adversely affects the cellular immune system and the susceptibility of individuals to infectious problems. In addition, weight loss of the degree commonly seen in the AIDS population places patients at risk of death because of resultant organ dysfunction. Moreover, severe weight loss may preclude recovery from infectious complications that otherwise would not represent a lethal challenge to the host. Because even appropriately directed therapies may not be successful when used in patients with severe weight loss, it is crucial to identify the mechanism of the weight loss associated with AIDS and to rapidly initiate evaluation of agents capable of altering or reversing this potentially lethal complication.