Antiretrovirals Need Food to be Effective
HIV/AIDS has a devastating impact on the health of individuals, families, communities, countries, and, by extension, regions. And in the Caribbean region, addressing this pandemic has never been more critical. As the region welcomes the millions of dollars promised through the Global Fund, mostly through antiretroviral (ARV) medication/drug regimes, it is essential to recognize that the combat to manage and survive disease has always involved nutrition. HIV/AIDS is no exception. The World Health Organization believes that better nutrition increases survival rates, primarily because of its effects on immune functions.
When the body primes itself to deal with an infection, including HIV, it tends to use up more calories and protein than usual. As a result, energy and nutrient requirements are increased. At the same time, appetite often diminishes, thereby leaving the body with fewer reserves to do more, with less support. Other infections and fever also increase the body's need for food. These needs increase even further as HIV/AIDS symptoms develop. With undesired weight and crucial protein losses, the body simply cannot survive. HIV-infection and malnutrition seem to be a mutually aggravating processes therefore, nutrition, not only quality but quantity, is fundamental to HIV/AIDS intervention.
Patients should be educated to understand that many of these potent ARV’s often need to be taken with food. This is because a certain amount of medication has to be maintained in the body in order for it to be effective against the virus. For some ARV’s, food not only boosts the amount of medication that gets into the body but also impacts the amount that stays there. Use of the right combination of food and ARV treatment is also important to ensure drug compliance and effectiveness.
We know that although good nutrition cannot prevent HIV infection or cure AIDS, it can help to maintain and improve the nutritional status of persons with this virus and very possibly, delay the progression from HIV to AIDS-related diseases.
While good nutrition will complement and reinforce the effect of many ARV’s, a consistent lack of food, known as food insecurity, and poor nutrition can diminish medication efficacy and adherence. This lack can also hasten the progression of diseases. As such, potent medications may be contraindicated in food insecure and nutritionally vulnerable groups.
As we welcome life-saving HIV/AIDS medications, we need to responsibly insure that as policies are created and resources mobilized, that we make certain that adequate food and nutrition are embedded with the policies for medication dissemination. Simply put, we must be aware that when people with HIV/AIDS are provided with a combination of medication and adequate nutrition, health advances are validated. But to provide these powerful drugs without food is like washing your hands and then drying them in mud.