Weight gain and increased concentrations of receptor proteins for tumor necrosis factor after patients with symptomatic HIV infection received fortified nutrition support.
OBJECTIVE
To determine whether certain nutrients and dietary factors act as modulators of the immune system and improve the nutritional status of immunocompromised patients.


METHODS
Controlled, double-blind, crossover phase trials of the effects of a fortified formula in patients infected with the human immunodeficiency virus (HIV). Patients consumed a control formula for 4 months and a study formula for 4 months.


METHODS
Ten men with symptomatic HIV infection who were following stable medication regimens and had no malignancies, mycobacteriosis, or additional virus infection requiring systemic treatment.


METHODS
Formula fortified with alpha-linolenic acid (1.8 g/day), arginine (7.8 g/day), and RNA (0.75 g/day) and a standard formula.


METHODS
Nutritional status determined by anthropometric, bioelectrical, biochemical, and dietary assessment; energy expenditure determined by indirect calorimetry; disease progression; CD4 lymphocyte counts; HIV p24 antigen plasma concentrations; tumor necrosis factor (TNF) receptor proteins; and compliance control parameters.


METHODS
Student's t tests for paired and unpaired data.


RESULTS
Fortified nutrition resulted in a weight gain (+ 2.9 kg/4 months vs -0.5 kg/4 months with the control formula, P < .05), an incorporation of eicosaenoic acid into erythrocyte cell membranes (+ 47% of baseline values, P < .05), and increased plasma arginine concentrations (96.8 +/- 45.1 vs 51.8 +/- 20.9 mumol/L, P < .01). The serum concentrations of the soluble tumor necrosis factor receptor (sTNFR) proteins increased during the study period (sTNFR 55 = + 0.23 vs -0.40 ng/mL, P < .001; sTNFR 75 = + 0.90 vs -0.36 ng/mL, P < .01), whereas no changes in CD4+ lymphocyte counts were observed.


CONCLUSIONS
Increasing dietary intakes of n-3 polyunsaturated fatty acids, L-arginine, and RNA increased body weight, possibly by modulating the negative effects of TNF.
Süttmann
U
U
Zentrum Innere Medizin und Dermatologie, Abteilung Klinische Immunologie, Lehrte, Germany.
Ockenga
J
J
Schneider
H
H
Selberg
O
O
Schlesinger
A
A
Gallati
H
H
Wolfram
G
G
Deicher
H
H
Müller
M J
MJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000886:Anthropometry; D001120:Arginine / Q000627:therapeutic use; D015496:CD4-Positive T-Lymphocytes / Q000473:pathology; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004734:Energy Metabolism / Q000502:physiology; D005526:Food, Formulated; D005527:Food, Fortified; D015488:HIV Antigens / Q000097:blood; D015658:HIV Infections / Q000097:blood* / Q000178:diet therapy*; D006801:Humans; D007107:Immune System / Q000502:physiology; D019787:Linoleic Acid; D008041:Linoleic Acids / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D012313:RNA / Q000627:therapeutic use; D018124:Receptors, Tumor Necrosis Factor / Q000032:analysis*; D015430:Weight Gain / Q000502:physiology*
D015488:HIV Antigens; D008041:Linoleic Acids; D018124:Receptors, Tumor Necrosis Factor; D012313:RNA; D001120:Arginine; D019787:Linoleic Acid