The role of nutrition and dietary supplements in the management of diarrhoea in HIV patients: a review of the literature

Diarrhoea is present in 28-60% of people living with human immunodeficiency virus (HIV). This condition is associated with malabsorption, nutritional risk, and higher incidence of infections and is one of the main causes of morbidity and mortality. Diarrhoea may be classified by duration and aetiology. Acute and chronic diarrhoea causes a reduction in dietary intake and also reduces the ability to absorb nutrients, leading to patient malnutrition and impacting their quality of life. The medical treatment for infectious diarrhoea is the eradication of pathogens; however, there is no specific treatment for non-infectious diarrhoea, which suggests the use of antisecretory medications, antimotility, and adsorbent agents. The use of non-pharmacological strategies such as the dietary modifications and nutrition supplements, specifically zinc, elemental diets, glutamine, fibre, and probiotics may decrease the duration of diarrhoea and may ameliorate the frequency and consistency of stool depositions. The goal of nutritional intervention is to promote the intake of energy and protein amounts needed to maintain or improve the nutritional status and quality of life. Despite promising data in individual strategies, further studies are needed to evaluate the multiple approaches in clinical practice. In this review, we aim to summarise the nutritional management and supplementation strategies for diarrhoea in HIV patients.