title: Effect of Vitamin B12 and folic acid supplementation on neuropsychiatric symptoms and immune response in HIV-positive patients.
abstract: BACKGROUND
  Micronutrients such as B12 and folic acid deficiencies are found in higher number in HIV-infected patients.
  
  
  OBJECTIVE
  We conducted a study to examine the effect of Vitamin B12 and folic acid supplementation on neuropsychiatric manifestations, CD4 count, and anthropometric measurements in HIV-positive patients.
  
  
  METHODS
  Three different groups of HIV patients, namely, HIV patients with tuberculosis, HIV patients with neuropsychiatric manifestations, and asymptomatic HIV patients with 50 patients in each group were included in the study. Baseline and follow-up CD4 count, anthropometric measurements, neuropsychiatric assessments, Vitamin B12, and folic acid estimation were done.
  
  
  RESULTS
  The prevalence of folic acid deficiency was 27.1% in Group I, 31.9% in Group II, and 23.4% in Group III. The prevalence of Vitamin B12 deficiency was 8.16% in Group I, 6.12% in Group II, and 4.16% in Group III. HIV patients with neuropsychiatric manifestations were noted to have the lowest mean mini-mental score. After the supplementation of vitamins, anthropometric measurements, MMSE as well as Hamilton depression scores, improved in all the three groups whereas Hamilton anxiety scores improved only in Group III. The CD4 count also improved in Groups I and II after the supplementation of vitamins.
  
  
  CONCLUSIONS
  Folic acid deficiency was highest among neuropsychiatric patients. The majority of people who had a folic acid deficiency have shown improvement in their neuropsychiatric assessment scores as well as CD4 count after its supplementation.
authors.affiliation: Department of Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
authors.forename: Prabha M
authors.initials: PM
authors.lastname: Adhikari
authors.affiliation: Department of Pharmacology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
authors.forename: Mukta N
authors.initials: MN
authors.lastname: Chowta
authors.affiliation: Department of Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
authors.forename: John T
authors.initials: JT
authors.lastname: Ramapuram
authors.affiliation: Department of Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
authors.forename: Satish B
authors.initials: SB
authors.lastname: Rao
authors.affiliation: Department of Medicine, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
authors.forename: Karthik
authors.initials: K
authors.lastname: Udupa
authors.affiliation: Department of Pharmacology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
authors.forename: Sahana D
authors.initials: SD
authors.lastname: Acharya
keywords: CD4 count; HIV; Vitamin B12; folic acid