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The effect of aging, nutrition, and exercise during HIV infection
HIV-infected children and adults are now expected to live longer, but at the same time, they are at risk for developing health complications as a consequence of a life with chronic viral infection, exposures to medications that carry their own toxicities and side effects, and the natural effects of aging on the immune system. Age-related immunosenescence can increase the challenges of controlling viral loads and optimizing CD4+ T-lymphocyte cell counts. Because immunosenescence is an inherent phenomenon that may be accelerated by HIV, strategies that can potentially modify this process should be used. Nutrition therapy may support the effectiveness of the medical treatments by improving cellular function through the supplementation of both macronutrients and micronutrients.

Physical activity, known to provide a number of benefits for noninfected individuals, can exert positive effects on metabolic and cardiovascular functions while not imposing deleterious effects on the immune system. Continued research is needed to further define the effects of optimal nutrition and physical activity on the immune system as HIV-infected individuals grow older.



Effects of vitamin E and C supplementation on oxidative stress and viral load in HIV-infected subjects.
Supplements of vitamin E and C reduce oxidative stress in HIV and produce a trend towards a reduction in viral load.



Randomized, Controlled Clinical Trial of Zinc Supplementation to Prevent Immunological Failure in HIV-Infected Adults
This study demonstrated that long-term (18-month) zinc supplementation at nutritional levels delayed immunological failure and decreased diarrhea over time. This evidence supports the use of zinc supplementation as an adjunct therapy for HIV-infected adult cohorts with poor viral control.



Micronutrients and HIV-1 disease progression.
These data suggest that micronutrient deficiencies are associated with HIV-1 disease progression and raise the possibility that normalization might increase symptom-free survival.



A randomised controlled trial of omega-3 fatty acid supplementation for the treatment of hypertriglyceridemia in HIV-infected males on highly active antiretroviral therapy.
Omega-3 fatty acids are likely to be an effective treatment for hypertriglyceridaemia in HIV-infected males on HAART.



Vitamin D deficiency in HIV-infected individuals: one more risk factor for bone loss and cardiovascular disease?
Vitamin D insufficiency has now reached epidemic proportions, even in healthy individuals living in the tropics. Recent data suggest the hypovitaminosis D association with metabolic syndrome, immune diseases, diabetes and hypertension. Little is known regarding the effects of HIV/Aids and its treatment on the metabolism of vitamin D. In HIV-positive patients, factors linked to the virus itself and the use of antiretrovirals may be added to the other causes of hypovitaminosis D.



Class of Antiretroviral Drugs and the Risk of Myocardial Infarction
Increased exposure to protease inhibitors is associated with an increased risk of myocardial infarction, which is partly explained by dyslipidemia.



Low Vitamin D among HIV-Infected Adults: Prevalence of and Risk Factors for Low Vitamin D Levels in a Cohort of HIV-Infected Adults and Comparison to Prevalence among Adults in the US General Population
Similar to findings in US adults generally, vitamin D insufficiency or deficiency is highly prevalent among HIV-infected adults and is associated with known risk factors. Observed associations of vitamin D levels with renal insufficiency and with use of ritonavir- and efavirenz-containing regimens are consistent with both HIV-related and therapy-mediated alterations in vitamin D metabolism.



N-acetylcysteine replenishes glutathione in HIV infection.
NAC treatment for 8 weeks safely replenishes whole blood GSH and T cell GSH in HIV-infected individuals. Thus, NAC offers useful adjunct therapy to increase protection against oxidative stress, improve immune system function and increase detoxification of acetaminophen and other drugs.



A randomized trial of multivitamin supplements and HIV disease progression and mortality.
Multivitamin supplements delay the progression of HIV disease and provide an effective, low-cost means of delaying the initiation of antiretroviral therapy in HIV-infected women.



The Role of HIV and Antiretroviral Therapy in Bone Disease.
Clinical studies support that both HIV and ART may accelerate bone mineral loss. Antiretroviral therapy may cause ostepenia by direct action of the drugs on bone cell components, or indirectly by increasing renal loss of phosphate or modifying Vitamin D metabolism.



Acetyl-l-carnitine: a pathogenesis based treatment for HIV-associated antiretroviral toxic neuropathy.
Serum acetyl-l-carnitine (ALCAR) levels are decreased in neuropathy associated with NRTI therapy. ALCAR enhances neurotrophic support of sensory neurons and promotes energy metabolism, potentially causing nerve regeneration and symptom relief.



Glutathione deficiency is associated with impaired survival in HIV disease
Findings presented here link GSHdeficiency to impaired survival of HIV-infected subjects and suggest a potential intervention to relieve this impairment.



Long-term effect of acetyl-L-carnitine for antiretroviral toxic neuropathy.
Treatment with acetyl-L-carnitine (ALCAR) has shown short-term symptomatic and histological improvement.



Restoration of blood total glutathione status and lymphocyte function following alpha-lipoic acid supplementation in patients with HIV infection.
Supplementation with alpha-lipoic acid may positively impact patients with HIV and acquired immune deficiency syndrome by restoring blood total glutathione level and improving functional reactivity of lymphocytes to T-cell mitogens.



Micronutrient supplementation increases CD4 count in HIV-infected individuals on highly active antiretroviral therapy: a prospective, double-blinded, placebo-controlled trial.
Micronutrient supplementation can significantly improve CD4 cell count reconstitution in HIV-infected patients taking HAART. The micronutrient supplement tested was well tolerated and may hold promise as an adjuvant therapy in the treatment of HIV.



Oxidants and Antioxidants in the Pathogenesis of HIV/AIDS
"Antioxidants offer a promising, natural, and inexpensive remedy that may not only alter the course of HIV infection to AIDS, but also prove invaluable in reaching out to poverty-stricken countries. "



Serum selenium, plasma glutathione (GSH) and erythrocyte glutathione peroxidase (GSH-Px)-levels in asymptomatic versus symptomatic human immunodeficiency virus-1 (HIV-1)-infection.
The results show that stages I-III of HIV-disease are characterized by significant impairments of antioxidative defenses provided by selenium, GSH-Px, SH-groups and GSH.



The effect of a 12-week course of omega-3 polyunsaturated fatty acids on lipid parameters in hypertriglyceridemic adult HIV-infected patients undergoing HAART: a randomized, placebo-controlled pilot trial.
PUFA (polyunsaturated fatty acids) therapy with DHA/EPA reduced triglyceride levels significantly compared with placebo in HIV-infected patients with HAART-associated hypertriglyceridemia.



Premature Decline of Serum Total Testosterone in HIV-Infected Men in the HAART-Era
Premature decline of serum T is common (16%) among young/middle-aged HIV-infected men and is associated with inappropriately low/normal LH and increased visceral fat. T deficiency occurs at a young age and may be considered an element of the process of premature or accelerated aging known to be associated with HIV infection. The role of HIV and/or HIV infection treatments, as well as the role of the general health state on the gonadal axis, remains, in fact, to be elucidated. Due to the low specificity of signs and symptoms of hypogonadism in the context of HIV, caution is needed in the diagnosis of hypogonadism in HIV-infected men with biochemical low serum T levels.