Nutritional therapy in human immunodeficiency virus (HIV) infection.

Malnutrition remains highly prevalent among individuals living with human immunodeficiency virus (HIV), and it continues to represent a critical determinant of health outcomes. The double burden of malnutrition-comprising both undernutrition and overweight/obesity-has significant clinical implications, as it not only affects disease progression but also complicates the management of HIV and its associated conditions. Undernutrition can exacerbate immune suppression and increase susceptibility to opportunistic infections, while overweight and obesity contribute to the rising burden of metabolic complications in this population. A structured, stepwise nutrition care process is therefore essential. This process should incorporate careful screening and assessment, with particular attention to HIV-related signs and symptoms such as gastrointestinal disturbances, altered metabolism, or changes in body composition. Individualized nutrition support must be tailored according to the patient's underlying nutritional status, disease stage, and treatment regimen, while also addressing co-morbidities and potential treatment-induced complications. Overall, the interaction between HIV infection and nutritional status is complex and bidirectional, with nutrition playing a pivotal role in influencing treatment response, quality of life, and survival. The four steps of the nutrition care process-screening, assessment, diagnosis, and development of a management plan-provide a systematic framework to guide clinical practice. Within this framework, practical and evidence-based dietary recommendations can be implemented to optimize care for individuals living with HIV.