SELECTED VITAMINS IN HIV-INFECTION - A REVIEW

In this article we review published studies on the role of serum micro nutrient levels in the natural history of HIV infection. Specifically, we have focused on vitamins B-12, E, A, and beta-carotene. Deficienci es of one or several of these vitamins have been associated with an ac celerated progression of HIV infection to AIDS. Most investigators hav e used serum micronutrient levels as an indicator of vitamin nutriture . However, serum levels are not always the most sensitive or specific indicators of vitamin status. Nonetheless, serum vitamin levels are re latively easy to obtain and have been studied in various HIV-infected populations in individuals at different stages of disease. Low serum B -12 levels have been associated with increased neurologic abnormalitie s, more rapid HIV disease progression, and increased AZT-related bone marrow toxicity. Low serum vitamin E levels have been associated with an increase in oxidative stress in HIV-infected individuals. However, early studies of vitamin E supplementation suggest that vitamin E may have important immunostimulatory properties. Studies of vitamin A defi ciency in HIV-infected populations have shown that low serum vitamin A levels are associated with increased mortality, more rapid disease pr ogression, and increased maternal-fetal transmission. However, there i s little evidence that vitamin A supplementation, beyond the correctio n of deficiency, is beneficial in HIV infection. Finally, several clin ical trials of beta-carotene supplementation have failed to show signi ficant or sustained improvements in the immune response of patients wi th HIV infection or AIDS.