VITAMIN-A DEPLETION IN-HOSPITAL AND CLINIC PATIENTS WITH ACQUIRED-IMMUNODEFICIENCY-SYNDROME - A PRELIMINARY-REPORT

The objective of this study is to assess the serum concentration and t he urinary depletion of vitamin A in patients with AIDS with acute ill ness (hospitalized) and without acute illness (clinic attenders); and to examine the relationship of serum and urinary retinol levels with w eight loss, patient survival, CD4 count, fever, and liver function. Se rum and urinary retinol of 26 patients from the AIDS clinic or hospita l of the University of Alabama at Birmingham (UAB) were measured using HPLC. Mean serum retinol was lower in hospital patients than in clini c attenders, although the difference was not statistically significant . However, urinary retinol loss was significantly higher in hospital p atients than clinic patients (0.09 +/- 0.12 vs. 0.04 +/- 0.12, p=0.019 3). There were significant correlations between urinary retinol excret ion and body weight loss in clinic patients and between urinary retino l loss and high serum bilirubin levels in hospital patients. A signifi cantly higher proportion of hospital than clinic patients lost body we ight during the last month before recruitment into the study (p=0.039) . Further, a significantly higher proportion of those who lost weight subsequently died than survived (p=0.015). Urinary loss of retinol was significantly predicted by increased body temperature (p=0.0069) and decreased CD4 count (p=0.0454) in clinic patients. No single variable predicted significantly the urinary retinol loss in hospital patients. The presence of acute illness in hospital patients with AIDS appeared to be a risk factor for low serum retinol and increased urinary excre tion of retinol. Greater urinary retinol loss and more severe illness are associated with body weight loss and death. (C) 1997 Elsevier Scie nce Inc.