Effect of proteins, amino acids, and other nitrogenated supplements on the skeletal muscle mass in people living with HIV (PLWH): A systematic review

Background & aims: Skeletal muscle losses (both quantitative and qualitative) and the consequent risk of sarcopenia are important issues in people living with HIV (PLWH), even when treated with antiretroviral therapies (ART). We aimed to conduct a systematic review (SR) investigating the effects of dietary interventions with proteins, amino acids, and other nitrogenated compounds on the skeletal muscle of PLWH.

Methods: We searched the published literature until August 24th, 2020, including clinical trials predominantly with AIDS-free PLWH treated with ART.

Results: From the 82 studies initially selected, 75 were excluded for the following reasons: nutritional interventions different from nitrogenated compounds; non-nutritional interventions; lack of information on body composition; and studies with most participants with AIDS. From the publications included (n = 7), the majority were performed with small and heterogeneous samples. None of the studies included any new-generation ART or pre- or post-exposition drugs. Two studies found benefits of supplementation on muscle mass; one was performed in a very unfavorable socioeconomic setting, and the supplementation was based on food-derived substances. The other study supplemented creatine, and its benefits were found only when combined with physical exercise training and only by one of the methods of body composition analysis (DXA).

Conclusions: Our results showed that nutritional interventions with proteins, amino acids, or other nitrogenated compounds could not improve the skeletal muscle mass in PLWH. Further studies are needed, with bigger sample sizes and more precise control of ART schemes.

Systematic review registration: PROSPERO registration number CRD42019139981.