HIV Related Wasting Syndrome (Slim Disease)

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Definition

Weight loss of more than 10%, plus either unexplained chronic diarrhea for more than one month, or unexplained prolonged fever for more than one month. This places the patient in WHO Clinical Stage 4 HIV disease and hence patient should be considered for ART.

• It is important to exclude treatable conditions, especially TB, and to treat them A chest Xray is mandatory.
• Emaciation: encourage a high calorie and protein diet. Add mineral and vitamin supplementation:

	Medicine	Adult dose	Frequency	Duration
	nicotinamide po	50mg	once a day	review
and	pyridoxine po	25-50mg	once a day	review
and	thiamine po	50mg	once a day	review

Further Management

• Treat according to results of investigations. Keep referrals to a minimum and refer only if alternative diagnosis is suspected e.g. malabsorption.
• Initiate antiretroviral therapy or switch ART medication if there is treatment failure