DIAGNOSIS
Detailed history, repeated clinical investigations and
BMI/LBM/BCM calculations are paramount in identifying
signs and symptoms of possible undernutrition. However,
blood investigations can be used to help guide the process
(Table 2 – not all mentioned). Albumin, iron and zinc concentrations
may decrease due to undernutrition but also as
the result of chronic inflammatory state. Only when it has
been resolved, their concentrations return to normal and
can objectively be utilized as markers of undernutrition.
On the other hand, HIV utilizes zinc for its own replication
and without cART zinc supplementation can actually lead
to viral load increase. It must be kept in mind that iron reserves
are rarely actually depleted during chronic inflammatory
state but more oft en they are ill-utilized. Only rarely
is there need for iron supplementation in HIV non-anemic
patients (3, 4).