Potential Role of Intermittent Fasting on Decreasing Cardiovascular Disease in Human Immunodeficiency Virus Patients Receiving Antiretroviral Therapy

Abstract

Cardiovascular disease (CVD) has become one of the commonest causes of comorbidity and mortality among People living with human immunodeficiency virus (HIV) (PLWH) on antiretroviral therapy (ART). Nearly 50% of PLWH are likely to have an increased risk of developing CVD, including coronary heart disease, cerebrovascular disease, peripheral artery disease and aortic atherosclerosis. Aside from the common risk factors, HIV infection itself and side effects of antiretroviral therapy contribute to the pathophysiology of this entity. Potential non-pharmacological therapies are currently being tested worldwide for this purpose, including eating patterns such as Intermittent fasting (IF). IF is a widespread practice gaining high level of interest in the scientific community due to its potential benefits such as improvement in serum lipids and lipoproteins, blood pressure (BP), platelet-derived growth factor AB, systemic inflammation, and carotid artery intima-media thickness among others cardiovascular benefits. This review will focus on exploring the potential role of intermittent fasting as a non-pharmacological and cost-effective strategy in decreasing the burden of cardiovascular diseases among HIV patients on ART due to its intrinsic properties improving the main cardiovascular risk factors and modulating inflammatory pathways related to endothelial dysfunction, lipid peroxidation and aging. Intermittent fasting regimens need to be tested in clinical trials as an important, cost-effective, and revolutionary coadjutant of ART in the fight against the increased prevalence of cardiovascular disease in PLWH.

Potential role for vitamin D vs. intermittent fasting in controlling aquaporin-1 and aquaporin-3 expression in HFD-induced urinary bladder alterations in rats

“…Additionally, fasting significantly reduced the amount of oxidative DNA damage ( Hazzaa et al, 2020 ). Furthermore, it was noted by Gnoni et al (2021) that IF decreased the amount of messenger ribonucleic acid (mRNA) that encodes iNOS in the rat hippocampus. Additionally, Khouchab et al (2020) discovered that prolonged IF enhances both nonendothelial and endothelial microvascular activities.…”

HIV Treatment and Obesity: What’s New?

“…Furthermore, the Mediterranean diet has been associated with increased abundances of Bifidobacterium after the intervention, which is linked to a beneficial profile [58]. Data are still lacking regarding the effects of intermittent fasting regimens in PLWH with obesity and directed clinical trials are warranted [63].…”

Immune markers and microbial factors are related with periodontitis severity in people with HIV

“…In PLWH, immune activation and systemic inflammation appear to be caused by the translocation of microbial products from the gut mucosal surfaces to the peripheral blood. Microbial translocation could, potentially, lead to systemic inflammation [26]. Current research is focusing almost exclusively on the large intestine as the site of microbial product translocation to the blood [27][28][29], while other mucosal sites, such as the oral cavity, have rarely been studied.…”