, blood stress, glucose metabolism, oxidative pressure, and inflammation and, consequently, impacts, blood stress, glucose

, blood stress, glucose metabolism, oxidative pressure, and inflammation and, consequently, impacts
, blood stress, glucose metabolism, oxidative stress, and inflammation and, consequently, impacts on the risk of cardiovascular diseases, diabetes, and obesity development [82]. Accordingly, the value of nutritional intervention was exhibited by a 2019 clinical controlled trial displaying how Tianeptine sodium salt Autophagy dietary modifications can improve oxidative pressure linked with metabolic and chronic comorbidities (obesity, hypertension, diabetes, and dyslipidemia), by rising the consumption of food containing antioxidant molecules like polyphenols, by decreasing the adipose tissue and improving the gut microbiome [13]. Within this setting, the current COVID-19 pandemic has contributed to additional worsening life-style habits both in PLWH and in the common population, as sedentary, low physical activity, and unhealthy eating behaviors became typical within the course of “locking-down” emergency procedures enforced by distinct countries [14,15]. Furthermore, race and financial disparities limiting access to HIV care have considerably grown throughout the final two years, minimizing or stopping, usual outpatient and inpatient services, access to treatment options, medical appointments, at the same time as investigations for screening or follow up of metabolic illnesses [16,17]. Consequently, an emerging metabolic diseases epidemic might be hidden around the corner [18] if appropriate Etiocholanolone Formula measures aren’t promptly undertaken–particularly in PLWH, who’re, accordingly towards the abovementioned causes, overexposed to these complications. Within this regard, an early diagnosis of HIV comorbidities is pivotal to a thriving global management of PLWH. Hence, the objective of this overview will be to summarize the current knowledge about prompt diagnosis of comorbidities in PLWH along with the consequent connected nutritional management, taking into account metabolic dysfunctions and cART metabolic toxicity, and in the end offering sensible dietary indications to physicians and nutrition specialists. 2. Nutritional Recommendations In accordance with Distinct Comorbidities 2.1. Cardiovascular Illnesses Cardiovascular illnesses (CVD) have an important impact on PLWH, given that they substantially improve their risk of mortality in comparison with the common population; on the other side, HIV infection itself is an independent threat aspect for cardiovascular ailments, in particular coronary artery disease and chronic heart failure [19,20]. Alonso, A. et al. [21] demonstrated, via the evaluation of a sizable insurance database which includes about 20,000 PLWH, an elevated danger of chronic heart failure and myocardial infarction in this population, independently of other risk elements, underlining the value of adopting preventive measures for CVD in PLWH [17]. This enhanced risk may be explained by multiple variables. At first, the predominant function of HIV infection is demonstrated by the robust correlation among the T CD4 cells count nadir, persistent HIV replication, and also the risk of CVD improvement [22,23]. Certainly, the continuous viral replication within lymphoid tissue perpetuates the existence of a pro-inflammatory state [246] by upregulating the inflammatory cytokines, for instance C-reactive protein, higher sensitivity C-reactive protein, IL-6, and D-dimer; deregulating the CD8 activity; and activating monocytes and macrophages. This process, in turn, enhances the atheromatic plaque formation, arterial thickness and stiffness, and endothelial alteration, and promotes cardiovascular events [279]. On top of that, PLWH have a higher-than-average plasma lev.