Abstract

HIV infection induces chronic immune activation, oxidative stress, and nutrient depletion, collectively influencing disease progression. Although antiretroviral therapy (ART) improves survival, it may exacerbate oxidative damage through mitochondrial toxicity. This narrative review synthesizes evidence from 1990 to 2024 on relationships among HIV infection, ART-induced oxidative stress, antioxidant status, and nutrition, with emphasis on sub-Saharan Africa. Findings indicate that HIV and ART increase reactive oxygen species, weaken antioxidant defenses, and disrupt nutrient metabolism. Micronutrient deficiencies, particularly vitamins A, C, and E, selenium, and zinc, are common among people living with HIV and associate with accelerated CD4 decline and increased opportunistic infections. Supplementation studies suggest that improving antioxidant and micronutrient status may reduce oxidative stress, enhance immune function, and improve ART tolerability, although outcomes vary by baseline nutrition, ART regimen, and adherence. Integrating targeted nutritional interventions into HIV care may mitigate oxidative damage and improve long-term outcomes, but further trials are required.

Keywords: HIV, Oxidative stress, Antiretroviral therapy, Nutrition-antioxidants