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Nutrition in the patient living with HIV/AIDS: a translational approach.

  • Foto del escritor: NUTRASCIENDE CUCS
    NUTRASCIENDE CUCS
  • 14 feb 2024
  • 4 Min. de lectura

Actualizado: 1 oct 2024

Salas-García Miguel Amaury*a

Pérez-Malta Paola Lizbeth*b


*a Doctorado en Ciencias de la Nutrición Traslacional, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Guadalajara 44320, Mexico.


*b Bachelor of Nutrition, Centro Universitario de Ciencias de la Salud (CUCS), Universidad de Guadalajara (UdeG), Sierra Mojada 950, Building “N”, Colonia Independencia, Guadalajara ZC 44340, Mexico.


The human immunodeficiency virus (HIV) and is final stage, Acquired Immunodeficiency Syndrome (AIDS), targets the human immune system, increasing susceptibility to infections and certain types of cancer (1). Although the disease has been identified since the 1980´s, it is still considered a pandemic that represents a vital public health problem, particularly in resource-limited countries such as Mexico (2). Although to date there is no treatment that eliminates the disease, antiretroviral treatment or ART (a combination of drugs) is capable of slowing its progression and limiting the damage it causes (3); however, 1 out of 4 individuals under ART fails in adhering to these drugs as a consequence of social, economic and nutritional reasons (4). Among the latter, HIV impact on the patient's nutritional status has been identified even in the early stages of this epidemic, where weight loss was considered as one of the most visible signs of malnutrition in patients progressing to AIDS (5). Interestingly, weight loss is associated with loss of both muscle and fat, and is often accompanied to a large extent by vitamin and mineral deficiencies, as well as alterations in blood lipid concentrations (4,6).


In most cases, multiple causes of malnutrition have been identified in patients living with HIV/AIDS. In this way, primary and secondary malnutrition have been described, both of which can coexist in patients. The former is due to inadequate consumption of food and essential nutrients, mainly because of lack of access and availability, while the latter is the result of mechanisms proper to HIV, such as increased energy expenditure, malabsorption or impairment in the utilization of nutrients (4,7,8). Regardless of the causes, malnutrition increases vulnerability to the different post-infection impacts, while also affecting the evolution and prognosis of the disease (7). Thus, compromised nutritional status results in accelerated progression of HIV to AIDS, as well as decreased adherence and response to ART therapy, and at the same time, exacerbates the socioeconomic impact of the disease (4).


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Despite the important role of nutrition in this disease, not enough importance has yet been given to it and more efforts are required to provide adequate nutritional assessment and treatment in patients living with HIV/AIDS. This justifies a translational approach, i.e., research that is able to link the following: basic research (such as molecular sciences), its application, its adaptation to the context in which it will be used, and its maintenance in society (9,10). In this sense, translational nutrition consists of 5 phases (T0 to T4) that may be applied at the service of patients living with HIV/AIDS (10). Phase T0 refers to the ability of researchers to identify the opportunities and needs of the population. In this sense, nutritional status has been detected as a factor influencing treatment response, disease progression and quality of life. On the other hand, phase T1 refers to the application of knowledge in possible scenarios. In this regard, it is necessary to transfer basic knowledge to the clinical scenario that addresses the nutritional needs of these patients. Phase T2 involves generating evidence-based clinical practice guidelines. This means that the knowledge obtained can be used by health professionals for the benefit of patients. Phase T3 represents the transition from the use of knowledge in small populations to broader groups, such as communities, and also includes the identification of barriers that interfere with its application. Finally, phase T4 allows knowledge to be applied at the societal level, for example, through government information campaigns and public policies that allow it to reach all patients, particularly the most vulnerable (9).


Patients living with HIV/AIDS constitute a population with specific nutritional requirements that would benefit largely from the improvement of their nutritional status (6), therefore it is necessary to direct efforts to respond to their health needs. As previously mentioned, translational research aims to shorten the distance between laboratory developments and clinical benefit to the patient. Thus, the translational nutrition approach will lead to a better understanding of the nutritional impact of HIV, as well as the study of possible food-derived compounds that may have a positive effect on the disease (11). This could translate into specific and precise nutritional strategies for HIV/AIDS, which in turn could reduce the burden of the disease for health systems and for the patients themselves.


Recommended readings:

  1. WHO. HIV/AIDS. Published 2021. https://www.who.int/news-room/fact-sheets/detail/hiv-aids

  2. Noris D, Pavía S, Dora D, et al. Características epidemiológicas de pacientes con vih-sida atendidos en un hospital del sur de la Ciudad de México durante 2011 a 2016. Asoc Mex Infectología y Microbiol Clínica,AC. 2018;38(3):67-98. https://www.medigraphic.com/pdfs/micro/ei2018/ei183c.pdf%0Ahttps://www.scopus.com/record/display.uri?eid=2-s2.0-85069446799&origin=resultslist&sort=plf-f&src=s&nlo=&nlr=&nls=&sid=1413e2b530796303080175745bb67b22&sot=b&sdt=cl&cluster=scopubyr%25252C%25252

  3. Palios J, Kadoglou NPE, Lampropoulos S. The pathophysiology of HIV-/HAART-related metabolic syndrome leading to cardiovascular disorders: The emerging role of adipokines. Exp Diabetes Res. 2012;2012. doi:10.1155/2012/103063

  4. Berhe N, Tegabu D, Alemayehu M. Effect of nutritional factors on adherence to antiretroviral therapy among HIV-infected adults: A case control study in Northern Ethiopia. BMC Infect Dis. 2013;13(1). doi:10.1186/1471-2334-13-233

  5. Myezwa H, Hanass-Hancock J, Pautz N. Investigating the interaction between human immunodeficiency virus, nutrition, and disability: A cross-sectional observational study. African J Prim Heal Care Fam Med. 2018;10(1):1-8. doi:10.4102/phcfm.v10i1.1663

  6. Weiss JJ, Sanchez L, Hubbard J, Lo J, Grinspoon SK, Fitch K V. Diet Quality Is Low and Differs by Sex in People with HIV. J Nutr. 2019;149(1):78-87. doi:10.1093/jn/nxy241

  7. Nanewortor BM, Saah FI, Appiah PK, Amu H, Kissah-Korsah K. Nutritional status and associated factors among people living with HIV/AIDS in Ghana: cross-sectional study of highly active antiretroviral therapy clients. BMC Nutr. 2021;7(1):1-8. doi:10.1186/s40795-021-00418-2

  8. Flores-López G, Flores-Arenales I. Suplementación nutricional, ganancia ponderal en pacientes con VIH / SIDA. RevSalJal. 2020;(1):58-62.

  9. Betancourt Bethencourt JA, Ramis Andalia RM, Mirabal Nápoles M. Investigación traslacional y transdisciplinaria en salud pública TT  - Translational and transdisciplinary research in Public Health. Rev Cuba Salud Pública. 2014;40(2):239-248. http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0864-34662014000200008&lang=pt%0Ahttp://www.scielosp.org/pdf/rcsp/v40n2/spu08214.pdf

  10. Rey R. Medicina Traslacional: una nueva denoMinación para una prácTica ancesTral investigación Traslacional en Medicina. Rev Hosp Niños (B Aires). 2016;58(262):142-148.

  11. Goga A, Doherty T, Manda S, et al. Translating new evidence into clinical practice: A quasi-experimental controlled before-after study evaluating the effect of a novel outreach mentoring approach on knowledge, attitudes and confidence of health workers providing HIV and infant feeding coun. BMJ Open. 2020;10(10):1-13. doi:10.1136/bmjopen-2019-034770


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