**3.4 Paneth cells and the human immunodeficiency virus and other viral infections**

The GIT is the trusted site for sequestration and subsequent elimination of pathogens following a viral infection. Immediately following the invasion by HIV or other viral infections, the virus is transported to active immune sites within the GIT. Some of the viruses are eliminated, whereas others remain dormant in tissues of the GIT. Paneth cells are involved during early and later phases following a viral infection. Regardless of the treatment status, diabetes mellitus, cardiovascular disease, dyslipidemia, and malignancies are more prevalent in HIV positive individuals than HIV negative individuals with the same conditions [51, 58]. Non-communicable diseases are responsible for a persistent reduction in the life expectancy of HIV positive individuals despite treatment with potent antiretroviral drugs [45]. A similar inflammatory process resulting from dysbiosis happens during chronic HIV infection and or treatment with ARVs, resulting in the same consequences of obesity and other non-communicable diseases [48, 51, 58, 71].

### **3.5 Paneth cells and obesity**

The quality of Paneth cells is influenced by an individual's nutritional status and dietary intake. A diet that is high in fat is detrimental to the Paneth cell. Obesity affects a significant proportion of the citizens of most countries in the world regardless of their socioeconomic status [68, 72, 73]. Individuals who are obese are at an increased risk of diabetes mellitus, cardiovascular disease, liver dysfunction, and colorectal cancer, all characterized by a state of a persistent inflammatory response. The development of obesity is preceded by dysbiosis, bacterial translocation and persistent systemic inflammation [40]. The link between dysbiosis and Paneth cells has been established in the sections above.
