Micronutrients and HIV-1 disease progression.
OBJECTIVE
To determine whether nutritional status affects immunological markers of HIV-1 disease progression.


METHODS
A longitudinal study, to evaluate the relationship between plasma levels of nutrients and CD4 cell counts, along and in combination with beta 2-microglobulin (beta 2M; AIDS index) over an 18-month follow-up.


METHODS
Biochemical measurements of nutritional status including plasma proteins, zinc, iron and vitamins B1, B2, B6, B12 (cobalamin), A, E, C and folate and immunological markers [lymphocyte subpopulations (CD4) and beta 2M] were obtained in 108 HIV-1-seropositive homosexual men at baseline and over three 6-month time periods. Changes in nutrient status (e.g., normal to deficient, deficient to normal), were compared with immunological parameters in the same time periods using an autoregressive model.


RESULTS
Development of deficiency of vitamin A or vitamin B12 was associated with a decline in CD4 cell count (P = 0.0255 and 0.0377, respectively), while normalization of vitamin A, vitamin B12 and zinc was associated with higher CD4 cell counts (P = 0.0492, 0.0061 and 0.0112, respectively). These findings were largely unaffected by zidovudine use. For vitamin B12, low baseline status significantly predicted accelerated HIV-1 disease progression determined by CD4 cell count (P = 0.041) and the AIDS index (P = 0.005).


CONCLUSIONS
These data suggest that micronutrient deficiencies are associated with HIV-1 disease progression and raise the possibility that normalization might increase symptom-free survival.
Department of Epidemiology and Public Health, University of Miami School of Medicine, Florida 33101, USA.
M K
MK
Baum
G
G
Shor-Posner
Y
Y
Lu
B
B
Rosner
H E
HE
Sauberlich
M A
MA
Fletcher
J
J
Szapocznik
C
C
Eisdorfer
J E
JE
Buring
C H
CH
Hennekens
D000328:Adult; D001798:Blood Proteins / Q000378:metabolism; D018791:CD4 Lymphocyte Count; D018450:Disease Progression; D005500:Follow-Up Studies; D015658:HIV Infections / Q000276:immunology*; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D014131:Trace Elements / Q000097:blood*; D014802:Vitamin A Deficiency / Q000276:immunology; D014806:Vitamin B 12 Deficiency / Q000276:immunology; D014815:Vitamins / Q000097:blood*; D015032:Zinc / Q000097:blood / Q000172:deficiency; D001613:beta 2-Microglobulin / Q000378:metabolism
D001798:Blood Proteins; D014131:Trace Elements; D014815:Vitamins; D001613:beta 2-Microglobulin; D015032:Zinc