title: Higher pre-infection vitamin E levels are associated with higher mortality in HIV-1-infected Kenyan women: a prospective study.
abstract: BACKGROUND
  Low vitamin E levels are often found in HIV-1 infection, and studies have suggested that higher levels may decrease the risk of disease progression. However, vitamin E supplementation has also been reported to increase CCR5 expression, which could increase HIV-1 replication. We hypothesized that vitamin E levels at HIV-1 acquisition may influence disease progression.
  
  
  METHODS
  Vitamin E status was measured in stored samples from the last pre-infection visit for 67 Kenyan women with reliably estimated dates of HIV-1 acquisition. Regression analyses were used to estimate associations between pre-infection vitamin E and plasma viral load, time to CD4 count <200 cells/muL, and mortality.
  
  
  RESULTS
  After controlling for potential confounding factors, each 1 mg/L increase in pre-infection vitamin E was associated with 0.08 log10 copies/mL (95% CI -0.01 to +0.17) higher set point viral load and 1.58-fold higher risk of mortality (95% CI 1.15-2.16). The association between higher pre-infection vitamin E and mortality persisted after adjustment for set point viral load (HR 1.55, 95% CI 1.13-2.13).
  
  
  CONCLUSIONS
  Higher pre-infection vitamin E levels were associated with increased mortality. Further research is needed to elucidate the role vitamin E plays in HIV-1 pathogenesis.
authors.affiliation: Department of Medicine, University of Washington, Seattle, Washington 98195, USA. grahamsm@u.washington.edu
authors.forename: Susan M
authors.initials: SM
authors.lastname: Graham
authors.forename: Jared M
authors.initials: JM
authors.lastname: Baeten
authors.forename: Barbra A
authors.initials: BA
authors.lastname: Richardson
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Bankson
authors.forename: Ludo
authors.initials: L
authors.lastname: Lavreys
authors.forename: Jeckoniah O
authors.initials: JO
authors.lastname: Ndinya-Achola
authors.forename: Kishorchandra
authors.initials: K
authors.lastname: Mandaliya
authors.forename: Julie
authors.initials: J
authors.lastname: Overbaugh
authors.forename: R Scott
authors.initials: RS
authors.lastname: McClelland
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000378:metabolism / Q000401:mortality*; D015497:HIV-1 / Q000472:pathogenicity*; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D011446:Prospective Studies; D016019:Survival Analysis; D019562:Viral Load; D014810:Vitamin E / Q000097:blood*; D014811:Vitamin E Deficiency / Q000821:virology
chemical_list: D014810:Vitamin E