Micronutrients in HIV Infection Without HAART: A Focus on Resource-Limited Settings

Globally, an estimated 35.3 million people were living with human immunodeficiency virus (HIV) in 2012. More than 95% of HIV infections are in developing countries. Sub-Saharan Africa is the most severely affected area, where approximately two-thirds of HIV-positive individuals live. Micronutrients deficiencies are common in HIV-infected adults and children, especially in resource-limited settings where diet is often inadequate to guarantee the recommended daily requirements. Several studies have reported micronutrient deficiencies to be associated with increased morbidity and mortality in HIV-positive subjects.In this chapter, we briefly review the main findings of observational studies and randomized controlled trials evaluating the impact of serum micronutrient levels (in particular vitamins A, D, C, E, B6, B12, folic acid, zinc, selenium, iron, and multiple supplements) on clinical outcomes of HIV-infected patients living in resource-limited settings. Moreover, we report on studies assessing the possible role of micronutrient supplementation as an adjunct treatment for children and adults with HIV infection.