A Step Closer to the “Fourth 90”: A Practical Narrative Review of Diagnosis and Management of Nutritional Issues of People Living with HIV
The quality of life of people living with HIV (PLWH) has remarkably increased thanks to the introduction of combined antiretroviral therapy. Still, PLWH are exposed to an increased risk of cardiovascular diseases, diabetes, chronic kidney disease, and liver disease. Hence, the purpose of this review...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-11-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/11/11/2047 |
| _version_ | 1797510635143036928 |
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| author | Davide Fiore Bavaro Paola Laghetti Mariacristina Poliseno Nicolò De Gennaro Francesco Di Gennaro Annalisa Saracino |
| author_facet | Davide Fiore Bavaro Paola Laghetti Mariacristina Poliseno Nicolò De Gennaro Francesco Di Gennaro Annalisa Saracino |
| author_sort | Davide Fiore Bavaro |
| collection | DOAJ |
| description | The quality of life of people living with HIV (PLWH) has remarkably increased thanks to the introduction of combined antiretroviral therapy. Still, PLWH are exposed to an increased risk of cardiovascular diseases, diabetes, chronic kidney disease, and liver disease. Hence, the purpose of this review is to summarize the current knowledge about diagnosis and nutritional management with specific indication of macro and micronutrients intake for the main comorbidities of PLWH. In fact, a prompt diagnosis and management of lifestyle behaviors are fundamental steps to reach the “fourth 90”. To achieve an early diagnosis of these comorbidities, clinicians have at their disposal algorithms such as the Framingham Score to assess cardiovascular risk; transient elastography and liver biopsy to detect NAFLD and NASH; and markers such as the oral glucose tolerance test and GFR to identify glucose impairment and renal failure, respectively. Furthermore, maintenance of ideal body weight is the goal for reducing cardiovascular risk and to improve diabetes, steatosis and fibrosis; while Mediterranean and low-carbohydrate diets are the dietetic approaches proposed for cardioprotective effects and for glycemic control, respectively. Conversely, diet management of chronic kidney disease requires different nutritional assessment, especially regarding protein intake, according to disease stage and eventually concomitant diabetes. |
| first_indexed | 2024-03-10T05:34:07Z |
| format | Article |
| id | doaj.art-1c8db410f77f4dd7ad95352e6574bfb7 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T05:34:07Z |
| publishDate | 2021-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-1c8db410f77f4dd7ad95352e6574bfb72023-11-22T23:01:35ZengMDPI AGDiagnostics2075-44182021-11-011111204710.3390/diagnostics11112047A Step Closer to the “Fourth 90”: A Practical Narrative Review of Diagnosis and Management of Nutritional Issues of People Living with HIVDavide Fiore Bavaro0Paola Laghetti1Mariacristina Poliseno2Nicolò De Gennaro3Francesco Di Gennaro4Annalisa Saracino5Clinic of Infectious Diseases, University Hospital Policlinico, University of Bari, 70124 Bari, ItalyClinic of Infectious Diseases, University Hospital Policlinico, University of Bari, 70124 Bari, ItalyUnit of Infectious Diseases, Policlinico “Riuniti”, 710121 Foggia, ItalyClinic of Infectious Diseases, University Hospital Policlinico, University of Bari, 70124 Bari, ItalyClinic of Infectious Diseases, University Hospital Policlinico, University of Bari, 70124 Bari, ItalyClinic of Infectious Diseases, University Hospital Policlinico, University of Bari, 70124 Bari, ItalyThe quality of life of people living with HIV (PLWH) has remarkably increased thanks to the introduction of combined antiretroviral therapy. Still, PLWH are exposed to an increased risk of cardiovascular diseases, diabetes, chronic kidney disease, and liver disease. Hence, the purpose of this review is to summarize the current knowledge about diagnosis and nutritional management with specific indication of macro and micronutrients intake for the main comorbidities of PLWH. In fact, a prompt diagnosis and management of lifestyle behaviors are fundamental steps to reach the “fourth 90”. To achieve an early diagnosis of these comorbidities, clinicians have at their disposal algorithms such as the Framingham Score to assess cardiovascular risk; transient elastography and liver biopsy to detect NAFLD and NASH; and markers such as the oral glucose tolerance test and GFR to identify glucose impairment and renal failure, respectively. Furthermore, maintenance of ideal body weight is the goal for reducing cardiovascular risk and to improve diabetes, steatosis and fibrosis; while Mediterranean and low-carbohydrate diets are the dietetic approaches proposed for cardioprotective effects and for glycemic control, respectively. Conversely, diet management of chronic kidney disease requires different nutritional assessment, especially regarding protein intake, according to disease stage and eventually concomitant diabetes.https://www.mdpi.com/2075-4418/11/11/2047HIVdiabetescardiovascular diseasechronic kidney diseaseliver diseaseNASH |
| spellingShingle | Davide Fiore Bavaro Paola Laghetti Mariacristina Poliseno Nicolò De Gennaro Francesco Di Gennaro Annalisa Saracino A Step Closer to the “Fourth 90”: A Practical Narrative Review of Diagnosis and Management of Nutritional Issues of People Living with HIV Diagnostics HIV diabetes cardiovascular disease chronic kidney disease liver disease NASH |
| title | A Step Closer to the “Fourth 90”: A Practical Narrative Review of Diagnosis and Management of Nutritional Issues of People Living with HIV |
| title_full | A Step Closer to the “Fourth 90”: A Practical Narrative Review of Diagnosis and Management of Nutritional Issues of People Living with HIV |
| title_fullStr | A Step Closer to the “Fourth 90”: A Practical Narrative Review of Diagnosis and Management of Nutritional Issues of People Living with HIV |
| title_full_unstemmed | A Step Closer to the “Fourth 90”: A Practical Narrative Review of Diagnosis and Management of Nutritional Issues of People Living with HIV |
| title_short | A Step Closer to the “Fourth 90”: A Practical Narrative Review of Diagnosis and Management of Nutritional Issues of People Living with HIV |
| title_sort | step closer to the fourth 90 a practical narrative review of diagnosis and management of nutritional issues of people living with hiv |
| topic | HIV diabetes cardiovascular disease chronic kidney disease liver disease NASH |
| url | https://www.mdpi.com/2075-4418/11/11/2047 |
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