Written by Renata Filiaci, MS Health and Wellness

Proper nutrition and vitamin and minerals replenishment is critical in patients with chronic illness. Human Immunodeficiency Virus (HIV) is a virus affecting the CD4+ T-helper cells of the immune system, as high levels of virus production continually replicate and destroy active CD4+ T-helper cells, which progresses into acquired immunodeficiency syndrome (AIDS). HIV disease progression has shown a decrease in essential nutrients due to rapid use of the compounds, poor digestion, and malabsorption. Increased intake of vitamins and minerals could potentially slow down the progression into AIDS as well as delay the requirement of antiretroviral therapy (Pizzorno & Murray, 2013). However, patients receiving highly active antiretroviral therapy may present severe symptoms, including weight loss, serum lipid abnormalities, malabsorption, diarrhea, lean tissue depletion, osteopenia, and cardiovascular diseases, which cause result in a nutrient deficiency; monitoring these levels in both instances presents itself as beneficial (Somarriba, Schaefer, & Miller, 2010; Pizzorno & Murray, 2013; Rezaei, Sedigh Ebrahim-Saraie, Heidari, Ghane, Rezaei, Manochehri, Moghadami, Afsar-Kazerooni, Hassan Abadi, & Motamedifar, 2016).

Food, nutrition, and a plentiful multivitamin are essential factors in receiving the necessary vitamins and minerals in HIV patients. Diets abundant in fruits, vegetables, herbs, and specific beverages, which contain flavonoids, have beneficial effects on the immune system of HIV patients. Flavonoids are a bioactive compound that works as an antioxidant, reducing oxidative stress caused by excess production of reactive oxygen species (Pizzorno & Murray, 2013; Raiten, 2011). However, some nutrients are needed in excess, in which additional supplementation is required. Considering the patient’s CD4+ count diminishes during HIV progression, it is best to increase the number. Vitamins and minerals, such as beta-carotene, vitamin B6, vitamin B12, selenium, acetyl-L-carnitine, and DHEA provide an improvement in CD4 cell and lymphocyte count, which decrease the chance of opportunistic infections and stimulate immune function (Pizzorno & Murray, 2013). Also, the addition of the mineral zinc in the diet reduces the risk of pneumonia, which is a prevalent infection in HIV patients, as well as recurring inflammation (Roohani, Hurrell, Kelishadi, & Schulin, 2013).

Due to malabsorption, HIV progression, and antiretroviral use causing a nutrient deficiency, it is necessary to receive an adequate amount of vitamin A, folate, vitamin B1, vitamin D, Vitamin E, magnesium, and glutathione/GSH to prevent deterioration, osteopenia, and virus progression (Pizzorno & Murray, 2013). When combined, vitamin A, C, and E work as free radical scavengers and limit oxidative stress, decreasing viral load (Somarriba, Schaefer, & Miller, 2010). Pizzorno (2013) references additional nutrients, such as NAC, CoQ10, L-arginine, EFA, and L-methionine, that could be of value in slowing down the progression of the virus by increasing CD4 and natural killer cell count, improving body mass, and lowering oxidative stress. Milk thistle and alpha-lipoic acid supplements improve liver function (Pizzorno & Murray, 2013). When milk thistle was co-administered with antiretroviral therapy, darunavir-ritonavir, for fourteen days, the researchers found that interaction between substances was safe for patients with HIV (Moltó, Valle, Miranda, Cedeño, Negredo, & Clotet, 2012).

Moltó, J., Valle, M., Miranda, C., Cedeño, S., Negredo, E., & Clotet, B. (2012). Effect of milk thistle on the pharmacokinetics of darunavir-ritonavir in HIV-infected patients. Antimicrobial agents and chemotherapy, 56(6), 2837-41. doi:  [10.1128/AAC.00025-12]

Pizzorno, J. E. & Murray, M. T. (2013). Textbook of Natural Medicine (4th ed.). St. Louis, MO: Elsevier Inc.

Raiten, D. J. (2011). Nutrition and pharmacology: general principles and implications for HIV. The American journal of clinical nutrition, 94(6), 1697S-1702S. DOI [10.3945/ajcn.111.019109]

Rezaei, E., Sedigh Ebrahim-Saraie, H., Heidari, H., Ghane, P., Rezaei, K., Manochehri, J., Moghadami, M., Afsar-Kazerooni, P., Hassan Abadi, A. R., & Motamedifar, M. (2016). Impact of vitamin supplements on HAART related hematological abnormalities in HIV-infected patients. Medical journal of the Islamic Republic of Iran, 30, 350. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4898844/

Roohani, N., Hurrell, R., Kelishadi, R., & Schulin, R. (2013). Zinc and its importance for human health: An integrative review. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences, 18(2), 144-57. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3724376/

Somarriba, G., Neri, D., Schaefer, N., & Miller, T. L. (2010). The effect of aging, nutrition, and exercise during HIV infection. HIV/AIDS (Auckland, N.Z.), 2, 191-201. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3218696/