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Vitamin E deficiency in early HIV infection

TreatmentUpdate. # 87, v. 10 n. 3, pp. 4-5. May, 1998
Hosein, SR Click here for french language version of article

Background and Summary

In people with HIV/AIDS, the intestine can come under attack by parasites and HIV itself. As a result, it becomes less efficient at absorbing nutrients and so it is not surprising that deficiencies of vitamins and minerals occur. HIV infection also places stress on the body's antioxidant defense system and likely increases the requirement for antioxidants such as vitamins C and E.

Researchers in the US have documented a vitamin E deficiency in about 22% of subjects in their study. They also found that in monitoring subjects for one year, vitamin E levels declined. As this nutrient plays an important role in protecting cells from harmful chemicals as well as enhancing the immune system's response to infections, supplementation with vitamin E by people with HIV/AIDS may be a good idea.

Study Details

This study had two parts. In the first stage, researchers recruited 121 adult HIV-infected subjects (15 females, 106 males) who had an average of 463 CD4+ cells, to measure the level of vitamin E in their blood. In the second stage, researchers monitored 42 subjects for one year to track the level of vitamin E in their blood. No subject was taking more than 10 mg of vitamin E/day.

Results -- part 1

On analysing the blood samples from 121 subjects, researchers found that the average level of vitamin E was 9 g/ml, which was about the middle of the normal range (5 g - 18 g) according to their laboratory. Further analysis found that 22% of subjects had less than 5 g/ml of vitamin E in their blood, indicating a deficiency. This deficiency was not linked to CD4+ cell counts nor age.

Results -- part 2

After monitoring 42 subjects for 1 year the researchers found that the average level of vitamin E in their blood fell by nearly 40%. This decrease was statistically significant, that is, not likely due to chance alone. During this time the CD4+ count also decreased significantly from an average of 461 cells to 391 cells.

This study is not the first to document a vitamin E deficiency in HIV/AIDS. Given the amount of stress placed on the antioxidant defense system by HIV infection, the requirement for vitamin E may be increased. In mice infected with a retrovirus that causes AIDS, supplementation with vitamin E restores some immune responses that were suppressed by the virus. Vitamin E may also protect CD4+ cells from unnecessary death. Nutritional support regimens for PHAs often suggest a minimum of 200 to 400 iu of vitamin E per day.

REFERENCES:

1. Walmsley SL, Winn LM, Harrison ML, et al. Oxidative stress and thiol depletion in plasma and peripheral blood lymphocytes from HIV-infected patients: toxicological and pathological implications. AIDS 1997;11(14):1689-1697.

2. Beharka A, Redican S, Leka L and Meydani SN. Vitamin E status and immune function. Methods in Enzymology 1997;282:247-263.

3. Pacht ER, Diaz P, Clanton T, et al. Serum vitamin E decreases in HIV-seropositive subjects over time. Journal of Laboratory and Clinical Medicine 1997;130:293-296.

4. Bauer MKA, Vogt M, Los M, et al. Role of reactive oxygen intermediates in activation-induced CD95 (APO-l/FAS) ligand expression. Journal of Biological Chemistry 1998;273(14):8048-8055.

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