Low carotenoid concentration and the risk of HIV seroconversion in Pune, India

Low vitamin A and carotenoid levels could increase the risk of sexual HIV a cquisition by altering the integrity of the genital epithelium or by immuno logic dysfunction. We addressed this issue by measuring serum vitamin A and carotenoid levels in patients who were at risk of subsequent HIV infection . In a nested case-control study in individuals attending two sexually tran smitted disease (STD) clinics in Pune, India, serum micronutrient levels we re measured in 44 cases with documented HIV seroconversion (11 women and 33 men) and in STD patients matched for gender and length of follow-up with n o subsequent HIV seroconversion (controls). STD patients in Pune had low vi tamin A and carotenoid levels, and low serum beta -carotene levels were ind ependently associated with an increased risk of subsequent HIV seroconversi on. STD patients with beta -carotene levels less than 0.075 mu mol/L were 2 1 times more likely to acquire KTV infection than those with higher levels (adjusted odds ratio = 21.1; p = .01). No such association was observed in case of other non-provitamin A carotenoids. This study reports the first ev idence of an association between low serum provitamin A carotenoid levels a nd an increased risk for heterosexual HIV acquisition in STD patients in Pu ne, India.