title: An investigation of the possible interaction between the use of Vitamin C and highly active antiretroviral therapy (HAART) adherence and effectiveness in treated HIV+ women.
abstract: OBJECTIVE
  Our goal in this study was to examine how Vitamin C interacts with antiretroviral therapy in individuals with HIV. We specifically evaluated how Vitamin C impacts highly active antiretroviral therapy (HAART) adherence and HAART effectiveness as adjudicated by HIV viral loads and CD4 cell counts. Women served as their own controls, comparing periods of Vitamin C usage with periods of non-usage.
  
  
  METHODS
  An intra-individual, cross-sectional comparative study 'nested' in the WIHS observational cohort study.
  
  
  METHODS
  Women in the Women's Interagency HIV Study (WIHS).
  
  
  METHODS
  Adherence, CD4 count and viral load.
  
  
  RESULTS
  Our study population was drawn from 2813 HIV+ participants who contributed 44,588 visits in WIHS from October, 1994 to April, 2009. Among them, there were 1122 Vitamin C users with 4954 total visits where use was reported. In the multivariate model adjusting for age, education, race, income, drug use, Vitamin C use order and depression score, there was a 44% increase in the odds of ≥ 95% HAART adherence among participants during their period of Vitamin C use compared to when they were not using Vitamin C (OR=1.44; 95% CI=1.1-1.9; P-value=0.0179). There was an association with Vitamin C usage and CD4 counts on viral loads.
  
  
  CONCLUSIONS
  Vitamin C usage appears to be associated with improved adherence. Future Vitamin C studies should target specific HAART drugs, and prospective clinical outcomes.
authors.affiliation: Department of Family Medicine, Georgetown University Medical Center, Washington, DC 20007, United States. djm23@georgetown.edu
authors.forename: Daniel
authors.initials: D
authors.lastname: Merenstein
authors.forename: Cuiwei
authors.initials: C
authors.lastname: Wang
authors.forename: Monica
authors.initials: M
authors.lastname: Gandhi
authors.forename: Esther
authors.initials: E
authors.lastname: Robison
authors.forename: Alexandra M
authors.initials: AM
authors.lastname: Levine
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: Schwartz
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Weber
authors.forename: Chenglong
authors.initials: C
authors.lastname: Liu
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D001205:Ascorbic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D006679:HIV Seropositivity / Q000188:drug therapy / Q000821:virology; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D010349:Patient Compliance; D016896:Treatment Outcome; D019562:Viral Load; D014815:Vitamins / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D019380:Anti-HIV Agents; D014815:Vitamins; D001205:Ascorbic Acid