Vitamin B12 malabsorption in patients with acquired immunodeficiency syndrome.
We have examined 11 patients with the acquired immunodeficiency syndrome (AIDS) for evidence of subclinical vitamin B12 malabsorption. Three subjects (27%) had low levels of vitamin B12. Eight subjects (73%), including these 3 subjects plus 5 others with normal vitamin B12 levels, had abnormal Schilling test results. In addition, 15% of an unselected population of 121 patients with AIDS and 7% of 27 patients without AIDS who were seropositive for human immunodeficiency virus type 1 (HIV-1) had low serum vitamin B12 levels. Stool cultures from the 8 subjects with abnormal Schilling test results revealed no pathogens. Intestinal involvement by Kaposi's sarcoma was found in only 1 patient. Biopsy specimens from 5 of 6 patients with vitamin B12 malabsorption, however, contained mononuclear cells harboring HIV-1, as indicated by in situ hybridization studies. Our observations suggest that vitamin B12 malabsorption is common in patients with AIDS and may be a very early manifestation of infection with HIV-1.
Laboratory of Clinical Investigation, National Institute of Allergy and Infectious Diseases, Bethesda, MD 20892.
G R
GR
Harriman
P D
PD
Smith
M K
MK
Horne
C H
CH
Fox
S
S
Koenig
E E
EE
Lack
H C
HC
Lane
A S
AS
Fauci
D000163:Acquired Immunodeficiency Syndrome / Q000378:metabolism*; D000328:Adult; D006801:Humans; D008286:Malabsorption Syndromes / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D014805:Vitamin B 12 / Q000097:blood*
D014805:Vitamin B 12