Nutrition in HIV and Tuberculosis

Nutritional compromise is one of the most frequent complications in both human immunodeficiency virus (HIV) and tuberculosis (TB) infections, and poor nutritional status may also increase risk for infection with either HIV or TB. Many health outcomes, particularly immunity, comorbidities, disease progression, and response to therapy, are influenced by an individual’s nutritional status and vice versa. The co-occurrence of HIV and TB, particularly in the presence of malnutrition, can further worsen malnutrition, typically resulting in worse outcomes than would be associated with HIV or TB alone. While the conditions and complications of these infections in the era before readily available and effective antiretroviral treatments persist in many parts of the world, the advent and success of antiretroviral therapy (ART) have led to a shift in healthcare priorities from AIDS-defining illnesses to noncommunicable diseases and conditions. A number of HIV-associated conditions are nutritionally relevant such as obesity, cardiovascular disease, and diabetes. Social determinants of health such as food insecurity and drug use are also important considerations that link HIV and TB with nutritional concerns. Nutritional therapy, such as micronutrient supplementation, may offer significant benefits in populations at risk for HIV and/or TB infections, as well as for individuals living with the infections, whether treated or not.