JANUARY 25 ― Our country currently has an estimated 87,000 people living with HIV (PLHIV). According to the World Health Organisation 2019 progress report on HIV, our national surveillance system notified nearly 78,000 PLHIV, of which 0.4 per cent were adolescents below 15 years old. [see note 1]

In people living with HIV, good nutrition promotes overall health and aids in immune system maintenance. This is a precursor to maintaining a healthy weight and absorbing HIV medications.

In Malaysia, less attention is given on the importance of nutrition among people living with HIV as the Covid-19 pandemic has directly resulted in a severe economic crisis resulting in surging food prices, the increase of vulnerability among the lower socioeconomic group (B40), and nutrition insecurity.

Nutritional assistance is not fully considered by the Malaysian government, despite the fact that it has implemented robust social protection schemes. [see note 2]

The immune system damaging disease causes harm on one's nutritional state, and poor nutrition takes its toll on the immune system, making one more vulnerable to secondary infections.

Limited awareness combined with food insecurity, especially given the relatively high costs of fresh, nutritious food, may be contributing to poor nutritional outcomes among people with HIV.

This in turn leads to poor eating habits and reduced nutritional intake particularly within the B40 community, where the diet may be lacking in essential vitamins and minerals. [see note 3]

Some micronutrients play critical roles in immune system maintenance, so routine supplementation may be beneficial. [see note 4]

Based on the World Health Organisation (WHO) Guide on Nutrition and Care Support, Consuming micronutrients (especially Vitamins A, B6 and B12, iron and zinc) is important for building a strong immune system and fighting infections. [see note 3]

Adverse nutritional outcomes, such as growth and metabolism abnormalities, are common in HIV-positive children and can contribute significantly to morbidity and mortality. [see note 3]

Based on the technical report by WHO on HIV/AIDS, the HIV/AIDS epidemic is affecting people that are already undernourished.

More political, financial, and technical support should be provided as soon as possible to improve nutritional quality and increase dietary consumption to recommended levels.

Based on the technical report by WHO on HIV/AIDS, the HIV/AIDS epidemic is affecting people that are already undernourished. — AFP pic

The take home message is that all national AIDS control and treatment programmes should include targeted, evidence-based nutrition interventions.

The Malaysian government continues to support the decentralised approach to health service provision, which includes community-based and primary health services linked to hospital-based care.

It provides treatment (ART), voluntary counselling and testing (VCT), psychosocial support, nutritional support and treatment for opportunistic infections, however lacking in nutritional intervention.

Continuity of nutrition services for children or adolescence living with HIV are crucial as adequate nutritional consumption improves the therapeutic action of medicines, strengthens the immune system (helping to fight disease and maintain body weight), delays the progression of HIV infection to AIDS, extends life expectancy, and promotes healthy living. [see note 5]

Last but not least, the parents, guardians or caretaker of adolescence with HIV should be proactive in supporting the adolescence by taking part in nutritional counselling in addition to providing a balanced diet for them.

* This is the personal opinion of the writer or publication and does not necessarily represent the views of Malay Mail.

** Notes

[1] Organisation WH. Progress report on HIV, viral hepatitis and sexually transmitted infections 2019: accountability for the global health sector strategies, 2016-2021. World Health Organisation; 2019.

[2] Ali Q, Parveen S, Yaacob H, Zaini Z, Sarbini NA. Covid-19 and dynamics of environmental awareness, sustainable consumption and social responsibility in Malaysia. Environmental Science and Pollution Research. 2021:1-20.

[3] Organisation WH. Antiretroviral therapy of HIV infection in infants and children: towards universal access: recommendations for a public health approach-2010 revision: World Health Organization; 2010.

[4] Visser ME, Durao S, Sinclair D, Irlam JH, Siegfried N. Micronutrient supplementation in adults with HIV infection. Cochrane Database Syst Rev. 2017;5(5):CD003650-CD.

[5] Organisation WH. Nutrient requirements for people living with HIV. 2004.