Abstract
HIV infection leads to ongoing immune activation and inflammation within gut-associated lymphoid tissue. Host response initiates events that participate in CD4+ T cell depletion and soft-tissue wasting. Chronic immune activation is associated with disruption of organized lymphoid tissue and gut-barrier integrity, and microbial translocation that may impact whole-body energy metabolism and protein turnover. Systemic stress leading to decreased food intake and/or viral damage to endocrine tissue is associated with wasting disease in HIV-infected patients. Clinical management requires appreciation of subjective, physical, and biochemical parameters, as well as addressing factors associated with food insecurity.