Exploring the impact of nutrition and autophagy on infectious diseases to inform the development of homeostatic-nanomedicines for HIV-TB coinfections

Tuberculosis (TB) and the human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) remain among the most difficult infectious diseases to manage globally, especially in developing countries. The two diseases have also been shown to have a synergistic relationship that worsens the negative effects of each disease on patient health, disease management, and overall socioeconomic outcomes. Both diseases have been shown to accelerate each other’s progression and are associated with multiple micronutrient deficiencies (MNDs), which further compromise immune competence and perpetuate a cycle of increased vulnerability to infectious diseases and progressive nutritional deterioration. Autophagy, an intracellular catabolic process partially induced by nutrient deprivation, has also been recognized as a vital host defence mechanism that reduces intracellular pathogen load and mitigates disease progression in both HIV and TB infections. Given the observed overlap between nutrition and autophagy, this review explores the roles of autophagy and nutrition to identify agents that can be used as homeostatic medicines. The use of nanoparticles (NPs) to deliver homeostatic nanomedicine-based host-directed therapies (HDTs) is also explored to examine how this strategy could help restore immune homeostasis in infected individuals, while offering an alternative or complementary approach to conventional treatments for HIV, TB, and HIV-TB coinfection.