Micronutrients and HIV-1 disease progression

Baum, Marianna K.; Shor‐Posner, Gail; Lü, Ying; Rosner, Bernard; Sauberlich, Howerde E.; Fletcher, Mary A; Szapocznik, José; Eisdorfer, Carl; Buring, Julie E.; Hennekens, Charles H.

doi:10.1097/00002030-199509000-00010

Cited by 226 publications

(132 citation statements)

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“…In observational studies, low micronutrient concentrations, including vitamin A and carotenoids, are associated with HIV disease progression, mortality and vertical viral transmission (Semba et al, 1993;Baum et al, 1995;Stephensen, 2003), and higher intake with delayed disease progression and survival (Tang et al, 1993;Tang et al, 1996). Vitamin A supplementation of children reduces morbidity and mortality of childhood infectious disease, specially with deficiency (Villamor and Fawzi, 2000), and supplementation of HIV-infected pregnant women improves some outcomes in the children (Kumwenda et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

A community randomized controlled clinical trial of mixed carotenoids and micronutrient supplementation of patients with acquired immunodeficiency syndrome

Austin¹,

Singhal

Voigt³

et al. 2006

Eur J Clin Nutr

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Objective: This clinical trial aims to evaluate if natural mixed carotenoids supplementation can improve the health and survival of acquired immunodeficiency syndrome (AIDS) patients. Design: A placebo-controlled, prospective, randomized, double-blind, multicenter clinical trial. Setting: Community, tertiary care human immunodeficiency virus (HIV) clinics of the Canadian HIV Trials Network (CTN). Participants: Three hundred and thirty-one adults with advanced AIDS on conventional management were recruited during routine clinic visits. Interventions: All participants, including 166 controls, received daily oral specially formulated multivitamins including vitamin A and trace elements; 165 treatment group participants received additional daily oral natural mixed carotenoids, equivalent to 120 000 IU (72 mg) of b-carotene daily. Follow-up was quarterly at routine clinic visits. Results: Mean (s.d.) follow-up was for 13 (6) months. Thirty-six participants died by 18 months. Serum carotene concentration o1.0 mmol/l was present in 16% participants at baseline. Despite variation in carotene content of the treatment medication, serum carotene concentrations increased significantly to twice the baseline levels to 18 months follow-up in participants who received carotenoids treatment compared with controls (Po0.0001). Although not statistically significant, mortality was increased in participants who did not receive carotenoids treatment compared with those who did (HR time to death 1.76, 95% CI 0.89, 3.47, P ¼ 0.11). In multivariate analysis, survival was significantly and independently improved in those with higher baseline serum carotene concentrations (P ¼ 0.04) or higher baseline CD4 T-lymphocyte counts (P ¼ 0.005). Adjusted mortality was also significantly and independently increased in those who did not receive carotenoids treatment compared with those who did (HR time to death 3.15, 95% CI 1.10, 8.98, P ¼ 0.03).

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Section: Introductionmentioning

confidence: 99%

A community randomized controlled clinical trial of mixed carotenoids and micronutrient supplementation of patients with acquired immunodeficiency syndrome

Austin¹,

Singhal

Voigt³

et al. 2006

Eur J Clin Nutr

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“…A number of observational studies have documented low dietary intake of zinc in large percentages of HIV-infected adults (Baum et al, 1994(Baum et al, , 2003Tang et al, 1996). By using zinc plasma concentrations, the prevalence of zinc deficiency among HIV-infected adults has been reported to be as high as 25-50% in some settings (Bogden et al, 1990;Beach et al, 1992;Baum et al, 1995Baum et al, , 1997bKoch et al, 1996), and to correlate positively with the stage of disease (Baum et al, 1997b;Bogden et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

Zinc supplementation to HIV-1-infected pregnant women: Effects on maternal anthropometry, viral load, and early mother-to-child transmission

et al. 2006

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Objective: To examine the effect of zinc supplementation to HIV-1-infected pregnant women on viral load, early mother-tochild transmission of HIV (MTCT), and wasting. Design: Double-blind placebo-controlled randomized clinical trial. Setting: Antenatal clinic in Dar es Salaam, Tanzania. Subjects: Four hundred HIV-1-infected pregnant women. Methods: Women 12-27 weeks of gestation were randomly assigned to receive a daily oral dose of 25 mg zinc or placebo from the day of the first prenatal visit until 6 weeks postdelivery. Weight and mid-upper arm circumference (MUAC) were measured monthly. HIV status of the babies was assessed at birth and at 6 weeks postpartum. Viral load was assessed in a random sample of 100 women at baseline and at the end of the study. Results: Zinc had no effects on maternal viral load or early MTCT. Supplementation was related to a significant threefold increase in the risk of wasting (reaching a MUAC value o22 cm) during an average 22 weeks of observation (RR ¼ 2.7, 95%CI ¼ 1.1, 6.4, P ¼ 0.03), and to a 4 mm decline in MUAC during the second trimester (P ¼ 0.02). Conclusions: Zinc supplementation to HIV-infected pregnant women offers no benefits on viral load or MTCT. The clinical relevance of an apparent decrease in MUAC associated with zinc supplementation is yet to be ascertained. These findings together with the lack of effect on fetal outcomes (reported previously) do not provide support for the addition of zinc supplements to the standard of prenatal care among HIV-infected women.

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“…The pathogenesis of malnutrition in AIDS is multifactorial and includes decreased food intake, decreased nutrient absorption and decreased ef®ciency of utilisation, combined with increased nutritional needs and increased tissue metabolism. An association between physiological micronutrient de®-ciences and disease progression was demonstrated in westernised populations (Baum et al, 1995), while a possible relationship between dietary intake and disease progression was also shown (Dworkin et al, 1990). Little is known, however, regarding the association between dietary intakes and disease progression in HIVaAIDS patients from developing populations, and further studies, especially in the African context, are recommended (Castetbon et al, 1997).…”

Section: Introductionmentioning

confidence: 99%

Nutritional status of HIV-1 seropositive patients in the Free State Province of South Africa: Anthropometric and dietary profile

et al. 1999

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Objective: To evaluate the nutritional intake and status of HIV-1 seropositive patients, as well as the relationship between malnutrition and disease stage. Design: A cross-sectional study. Settings: The Immunology Clinic at the Pelonomi Hospital in Bloemfontein, South Africa. Subjects: Eighty-one HIVaAIDS patients in different stages of disease were recruited consecutively from January to May 1995. Eleven of these patients were followed in 1997. Main outcome measures: Anthropometric data including current weight, height, triceps skinfold thickness, midupper-arm circumference, body mass index and bone-free arm muscle area were collected. Nutrient intake was estimated using a diet history in combination with a standardised food frequency questionnaire. The patients were divided into 3 groups according to their CD4 T cell counts. Results: The men were leaner (BMI 18.9) than the women (BMI 22.7) and patients with a CD4T cell count`200 (stage III) tended to have the lowest median values for all anthropometric measurements. More than half the patients had a low intake (`67% of the recommended dietary allowances) of vitamin C, vitamin B 6 , vitamin D, vitamin A, calcium, iron and zinc. Conclusions: The results con®rms that HIVaAIDS patients from this population are malnourished. There was, however, no association between disease stage and nutritional status. Nutritional supplementation of HIVaAIDS patients should be considered, as this might lead to improved immune function in these patients.

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Micronutrients and HIV-1 disease progression

Cited by 226 publications

References 0 publications

A community randomized controlled clinical trial of mixed carotenoids and micronutrient supplementation of patients with acquired immunodeficiency syndrome

A community randomized controlled clinical trial of mixed carotenoids and micronutrient supplementation of patients with acquired immunodeficiency syndrome

Zinc supplementation to HIV-1-infected pregnant women: Effects on maternal anthropometry, viral load, and early mother-to-child transmission

Nutritional status of HIV-1 seropositive patients in the Free State Province of South Africa: Anthropometric and dietary profile

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