**Abstract**

The innovations in the medical science and development of new biotechnology medicines changed significantly the course of the human immune-deficiency virus (HIV) infection toward a chronic condition. Along HAART, habits in nutrition place an important role in the improvement of the health status of people living with HIV. Proper diet and nutrition may enhance the adherence and concordance to prescribed therapy and its effectiveness, to reduce the risk of adverse drug events and to boost the immune function. In the resent years a tendency towards increased food supplements consumption is observed, especially in patients with chronic diseases. There is a risk of possible interactions between selected dietary supplements with the antiretroviral medicines which may result in decrease of the drug concentrations in the blood plasma and subsequent decreased therapeutic effect and increased risk of viral resistance. Still there are gaps in respect with such information in the guidelines and recommendations for treatment, monitoring and nutrition in HIV. More studies are needed to fully evaluate such interactions and to put recommendations both for the healthcare professionals and for the people living with HIV for their use in order not to compromise HAART and to maintain the desirable therapeutic outcome.

**Keywords:** HIV, nutrition, food supplements, highly active antiretroviral therapy, interactions

### **1. Introduction**

The innovations in the medical science and development of new biotechnology medicines changed significantly the course of the human immune-deficiency virus (HIV) infection towards a chronic condition. The advancement of the highly active antiretroviral therapy (HAART) led to significant increase in the life expectancy allowing people living with HIV to have a near-normal life-expectancy while meeting a variety of acute and chronic care needs [1].

Along HAART, nutrition habits place an important role in the improvement of the health status of people living with HIV. Proper diet and nutrition (foodbased attitude and micronutrient supplementation) may enhance the adherence and concordance to prescribed therapy and its effectiveness, to reduce the risk of adverse drug events and to boost the immune function. On the other side, one of

the main concerns in terms of nutrition habits, especially food supplement intake, is related to possible interactions with the antiretroviral medicines which may result in decrease of the drug concentrations in the blood plasma and subsequent decreased therapeutic effect and increased risk of viral resistance [2]. In this respect there are still gaps of scientific evidence for the antiretroviral drug-to-supplement interactions and only a few dietary supplements (i.e., Ca, Mg, Fe supplements) have been evaluated in combination with the currently available on the pharmaceutical market antiretroviral medicines [3, 4]. While, there is a tendency towards increased consumption of food supplements among patients with chronic diseases, healthcare providers should monitor their patients for potentially important drug—supplement interactions. People living with HIV should also be willing to communicate with their healthcare providers any administration of dietary supplements and special nutrition regimes in order to optimize their intake in compliance with the prescribed HAART and to avoid possible undesirable interactions.

It is a matter of national practices of the competent authorities and healthcare providers to provide reliable knowledge and adequate nutrition habits in people living with HIV to assure increased compliance and to maintain the effectiveness of the therapy.
