title: Association between serum vitamin A and E levels and HIV-1 disease progression.
abstract: OBJECTIVE
  To examine the associations between serum vitamin A and E levels and risk of progression to three key outcomes in HIV-1 infection: first AIDS diagnosis, CD4+ cell decline to < 200 cells x 10(6)/l, and mortality.
  
  
  METHODS
  Non-concurrent prospective study.
  
  
  METHODS
  Serum levels of vitamins A and E were measured at the enrollment visit of 311 HIV-seroprevalent homo-/bisexual men participating in the Baltimore/ Washington DC site of the Multicenter AIDS Cohort Study. Cox proportional hazards models were used to estimate the relative hazard of progression to each outcome over the subsequent 9 years, adjusting for several independent covariates.
  
  
  RESULTS
  Men in the highest quartile of serum vitamin E levels (> or = 23.5 mumol/l) showed a 34% decrease in risk of progression to AIDS compared with those in the lowest quartile [relative hazard (RH), 0.66; 95% confidence interval (CI), 0.41-1.06)]. This effect was statistically significant when comparing the highest quartile of serum vitamin E to the remainder of the cohort (RH, 0.67; 95% CI, 0.45-0.98). Associations between serum vitamin A levels and risk of progression to AIDS were less clear, but vitamin A levels were uniformly in the normal to high range (median = 2.44 mumol/l). Similar trends were observed for each vitamin with mortality as the outcome, but neither vitamin was associated with CD4+ cell decline to < 200 cells x 10(6)/l. Men who reported current use of multivitamin or single vitamin E supplements had significantly higher serum tocopherol levels than those who were not taking supplements (P = 0.0001). Serum retinol levels were unrelated to intake of multivitamin or single vitamin A supplements.
  
  
  CONCLUSIONS
  These data suggest that high serum levels of vitamin E may be associated with slower HIV-1 disease progression, but no relationship was observed between retinol levels and disease progression in this vitamin A-replete population.
authors.affiliation: Department of Epidemiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Tang
authors.forename: N M
authors.initials: NM
authors.lastname: Graham
authors.forename: R D
authors.initials: RD
authors.lastname: Semba
authors.forename: A J
authors.initials: AJ
authors.lastname: Saah
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000097:blood / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D015415:Biomarkers; D015331:Cohort Studies; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014801:Vitamin A / Q000097:blood*; D014810:Vitamin E / Q000097:blood*
chemical_list: D015415:Biomarkers; D014801:Vitamin A; D014810:Vitamin E