Editor,—The study by Carbonnelet al (Gut1997;41:805–10) on macronutrient intake and steatorrhoea in HIV infected patients tackles one important clinical feature of HIV infection. On admission to hospital up to 60% of patients with AIDS are underweight (>10% weight loss).1Even asymptomatic patients at an early stage of disease have changes in body composition as shown by a reduction in body cell mass, which is associated with an increased mortality and morbidity.2 HIV associated malnutrition has a multifactorial origin but as shown by Carbonnel et al and other authors steatorrhoea is a common problem in HIV infected patients, especially in those with opportunistic infections of the gastrointestinal tract.3 Inadequate energy intake is a major determinant of malnutrition in …