URINARY-EXCRETION AND PLASMA VITAMIN-E LEVELS IN PATIENTS WITH AIDS

Individuals with acquired immunodeficiency virus (HIV) and patients wi th acquired immunodeficiency syndrome (AIDS) present a variety of path ologic alterations that influence their nutritional status during vari ous stages of the disease. Previous studies have reported a reduction in plasma vitamin E levels in these patients associated with a higher production of free radicals. Individuals with infection, fever, or acu te diarrhea excrete considerable amounts of vitamin A in urine. This o bservation raised the hypothesis that this may also be the case for vi tamin E and that its urinary excretion may play a significant role in the reduction of plasma vitamin E levels. In the present investigation , 28 serologically positive HIV-1 (HIV group) divided into a group of 16 patients with AIDS (< 200/mm(3) CD4(+) T lymphocytes) were studied. The control group consisted of 11 healthy individuals. Urinary and pl asma vitamin E levels were determined by high-performance liquid chrom atography. Patients with AIDS presented reduced plasma vitamin E level s (15.25 +/- 12.19 mu mol/L) compared with the HN (26.40 +/- 17.01 mu mol/L) and control (40.03 +/- 31.80 mu mol/L) groups. On the other han d, urinary excretion was higher in the AIDS group (0.86 +/- 0.99 mu mo l/24 h) than in the HIV group (0.62 +/- 0.46 mu mol/24 h) and consider ably higher than in the control group (0.05 +/- 0.13 mu mol/24 h). The se results indicate elevated vitamin E excretion in the urine of both patients with AIDS and patients with HIV-1, leading to a reduction in the plasma level of this vitamin. Therefore, systematic monitoring of plasma and urinary vitamin E levels is recommended for patients with H IV and patients with AIDS and, if necessary, the combination of existi ng medical therapy with vitamin supplementation to maintain the nutrit ional status related to vitamin E. (C) Elsevier Science Inc. 1998.