HIV positive patients generally exhibit protein deficiency, besides deficiency in micronutrients like zinc, folic acid and vitamin B-12. According to nutritionist Varuna Kochar, these deficiencies reduce the host's defence and accelerate the development of AIDS. ``In fact, they themselves cause a variety of immune and metabolic abnormalities, also seen in AIDS patients,'' she adds.

In the West, supplements of specific nutrients like zinc, vitamins B, C and E, selenium and beta-carotene are, therefore, regularly given (along with the drug therapy) to HIV positive persons and those suffering from AIDS to improve their immune system.

Kochar, who recently came out with a book, Role of Micronutrients in AIDS, following a study on the subject, says: ``It is a pity that in our country, the nutritional aspect has not been given due importance in the management of HIV and AIDS. The focus has so far been restricted to their prevention and clinical management alone.''

Dr Chinkolal Thangsing, who is currently treating 176 HIV and AIDS patients at Michael's Care Home, a hospice for AIDS patients in south Delhi, agrees: ``Most doctors treating such people are usually so concerned with looking out for opportunistic infections (fungal, viral and bacterial) and their timely management that they tend to overlook the nutritional deficiency.''

Kochar quotes from her book to explain how micronutrient deficiencies can contribute to the development of AIDS and AIDS-associated symptoms among HIV positive patients and why the clinical latency of HIV varies from one patient to another. It is probably for the first time in India that a small attempt has been made at laying down the nutritional parameters to help HIV positive persons keep AIDS away for a longer period.

She also suggests that even factors like frequent seminal emissions in men, pregnancy and use of oral contraceptives by women, alcohol and drugs (like cocaine, morphine, heroin, marijuana and nitrite inhalants) can cause deficiency of micronutrients in body. HIV positive persons who have been associated with any of these factors must, therefore, be evaluated and nutritionally compensated in an adequate manner.

According to Dr Thangsing, loss of protein due to chronic diarrhoea and anaemia, though common among almost all AIDS patients, are adequately handled by the doctors. Several viral and nutrition-related problems could indeed be avoided by focusing more on specific nutritional requirements, along with the usual drug therapy and the exercise, to enable them lead a healthier life.

Neelam Kapoor, spokesperson of the National Aids Control Organisation (NACO), however, maintains that the issue of nutrition had little relevance for the poorer sections, for whom ensuring a regular balanced diet was a big challenge.