Martínez-Rojano H, Gorbea RMC

Idioma: Español
Referencias bibliográficas: 33
Paginas: 264-269
Archivo PDF: 57.44 Kb.

RESUMEN

La desnutrición asociada a la infección por virus de la inmunodeficiencia humana (VIH) es reversible, debe evaluarse y tratarse precozmente. El agente etiológico responsable del síndrome de desgaste puede sospecharse usando un algoritmo de diagnóstico. La tarea principal por identificar es la desnutrición, lo que puede ser difícil ya que los cambios tempranos son sutiles; la valoración nutricia periódica es útil e indispensable. La evaluación debe incluir una historia clínica completa y un examen físico minucioso, una valoración bioquímica e inmunológica y medidas antropométricas con especial atención en el peso, la talla, las circunferencias y los pliegues cutáneos, además de los cambios en el apetito, los hábitos alimenticios, y el estado funcional. Deben resolverse los problemas de masticación o deglución, incluyendo la candidiasis bucal, las úlceras aftosas, la gingivitis, la leucoplaquia, las lesiones herpéticas, y el sarcoma de Kaposi oral. Una disminución del apetito, sin causa aparente, debe tomarse como una advertencia. Algunas infecciones, incluso el citomegalovirus y el Complejo Mycobacterium avium (MAC), pueden tener un curso clínico lentamente progresivo, causando con pérdida del apetito y alteraciones nutricias hasta por más de dos meses, antes del desarrollo de síntomas específicos. Por esta razón la supervisión cuidadosa del estado nutricio y las características de la fiebre, podrían ser las evidencias más tempranas de una infección por un algún germen oportunista.

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