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Published on July 30, 2007

In a small room at the Thai Red Cross Society's Aids research centre, dietician Chintana Chaturawit gives group recommendations on good eating.

Despite carrying the HIV/Aids virus, these people appear well fed and do not look ill.

"With the anti-retroviral drugs these patients have been receiving, they are facing a new kind of nutrition problem. They no longer lack appetite and have fat levels that are too high, as is their blood sugar," centre director Dr Praphan Phanuphak said.

Since the virus hit Thailand, the country has concentrated on treating HIV/Aids patients but has overlooked their nutritional problems.

These are a challenge for Aids treatment programmes. Many Aids patients die, he said, because poor nutrition weakens their immune systems and allows the onset of other illnesses, including diabetes and heart disease.

That is why the research centre launched a pilot project to enhance the care of people living with HIV/Aids through improved nutrition.

Tachin, or Thai-Australian Collaboration in HIV Nutrition started in October 2005 in partnership with Mahidol University Institution of Nutrition and the Sydney-based Albion Street Centre.

Funding from the Australian Agency for Inter-national Development has paid for the project until next year.

During the project's term, twice a week, Chintana and other two nutritionists give dietary advice to people living with HIV/Aids and being treated at the centre.

"The virus changes patients' metabolism. They don't get energy from burning fat like uninfected people but from burning protein," Chintana said.

However, Chintana added there was no "instant formula" for nutrition for people with HIV. "It depends on the individual. But all of them need more protein."

Giving nutritional advice to HIV/Aids patients is just one aspect of the Tachin project.

The main point of the project is to build nutritional awareness among those who provide treatment or take care of patients. The nutritionists often give lectures to hospital staff and those providing psychological care for people living with HIV/Aids.

Somchart Thakaeng, deputy manager of Wednesday's Friends - an organisation of people with HIV giving advice and support to fellow sufferers - said the Tachin project really benefits patients. Before Tachin, they never considered nutrition an issue.

"We never thought about our metabolisms. We just ate anything. We believed all food could increase our immunity," he said.

In the two years Tachin has run the pilot, Praphan has appreciated its efforts. Patients receiving treatment at his centre have seen improved nutrition and risks of diabetes, strokes and heart disease reduce. He cannot offer exact numbers, saying he will know more at the end of the study.

"We know they have improved health because we provide medical check-ups," he said.

Praphan recommended the National Health Security Office include a nutrition package in annual examinations for all Aids patients, as well as providing anti-retroviral drugs.

"Levels of fat and sugar in patients' blood relate to numbers of CD4 receptors. To keep these in appropriate numbers, they need good nutrition to maintain the balance of fat and sugar. So, it's wise to check for fat and sugar," he said.

Pennapa Hongthong

 The Nation