Siddi Carlotta, Balla Jihane, Agbey Christy, Fadda Paola, Dedoni Simona
Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Cagliari, Italy.
Department of Neuroscience, Georgetown University Medical Center, Washington, DC 20057, USA.
Life (Basel). 2025 Jun 19;15(6):982. doi: 10.3390/life15060982.
HIV-associated neurocognitive disorders (HANDs) refer to a range of cognitive deficits that afflict people living with the Human Immunodeficiency Virus (HIV). The fundamental processes of HAND include persistent inflammation, immunological activation, and direct viral impact on the central nervous system. Emerging research shows that nutritional status, especially food consumption and body weight, is critical in determining the course and severity of HAND. Malnutrition exacerbates neurocognitive impairment by increasing inflammation and oxidative stress, while obesity may contribute to HAND through the promotion of metabolic disruption, gut microbiota alterations, and systemic inflammation. Additionally, the introduction of antiretroviral treatment (ART) has substantially enhanced the prognosis of people living with HIV by lowering viral load and improving immune function. However, depending on the regimen, ART can cause changes in body weight, which may influence the progression of HAND. This emphasizes the intricate interplay between HIV, nutrition, body weight, and neurocognitive health. As a result, various dietary approaches are currently being investigated to improve the quality of life of individuals with HIV and possibly help prevent neurocognitive decline in this population. This review aims to elucidate the relationship between nutrition and neurocognitive function in individuals living with HIV, shedding light on aspects of HANDs related to diet, body weight fluctuations, and metabolic syndrome. It explores the shift from current pharmacological treatments to innovative non-pharmacological interventions, including specific dietary strategies, to support overall health and cognitive well being in HIV-positive people.
人类免疫缺陷病毒（HIV）相关神经认知障碍（HANDs）指的是一系列折磨人类免疫缺陷病毒（HIV）感染者的认知缺陷。HANDs的基本发病过程包括持续炎症、免疫激活以及病毒对中枢神经系统的直接影响。新出现的研究表明，营养状况，尤其是食物摄入和体重，在决定HANDs的病程和严重程度方面至关重要。营养不良通过加剧炎症和氧化应激而加重神经认知障碍，而肥胖可能通过促进代谢紊乱、肠道微生物群改变和全身炎症而导致HANDs。此外，抗逆转录病毒治疗（ART）的引入通过降低病毒载量和改善免疫功能，显著提高了HIV感染者的预后。然而，根据治疗方案的不同，ART可能会导致体重变化，这可能会影响HANDs的进展。这强调了HIV、营养、体重和神经认知健康之间复杂的相互作用。因此，目前正在研究各种饮食方法，以提高HIV感染者的生活质量，并可能有助于预防该人群的神经认知衰退。这篇综述旨在阐明HIV感染者营养与神经认知功能之间的关系，揭示与饮食、体重波动和代谢综合征相关的HANDs的各个方面。它探讨了从当前的药物治疗向创新的非药物干预措施的转变，包括特定的饮食策略，以支持HIV阳性人群的整体健康和认知健康。
