Micronutrients in HIV/AIDS: is there evidence to change the WHO 2003 recommendations?

Forrester, Janet E.; Sztam, Kevin A.

doi:10.3945/ajcn.111.011999

Cited by 27 publications

(24 citation statements)

References 45 publications

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“…Although it is clear that vitamin A deficiency is detrimental to HIV+ individuals, approaches for vitamin A supplementation that are clearly both safe have yet to be developed (33, 34). Therefore, as future studies are pursued to understand the role of vitamin A deficiency in the risk of nervous system complications, it is important to also develop approaches for correcting the deficiency in affected individuals.…”

Section: Discussionmentioning

confidence: 99%

Effects of Vitamin A Deficiency and Opioids on Parvalbumin + Interneurons in the Hippocampus of the HIV-1 Transgenic Rat

Guo¹,

Bryant²,

Sultana³

et al. 2012

CHR

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Opioid use in HIV infection has been associated with an increased frequency of neurological disease and cognitive impairment and vitamin A deficiency has been linked to progressive HIV disease in drug users. In this report the potential effects of these factors, alone and in combination, on gamma amino butyric acid (GABA)-expression interneurons in hippocampus in the HIV-1 transgenic rat (TG) model were studied. TG and wild-type (WT) F344 Fisher rats that were vitamin A deficient from birth were implanted either with a 37.5 mg morphine tablet or with a matching placebo and total numbers of neurons and of parvalbumin+ neurons were quantitated and parvalbumin expression was quantitated in the CA1 hippocampal region of the rats. These studies showed that total neuronal numbers were decreased in the TG versus WT Fisher rats and that this decrease was enhanced by the vitamin A deficient diet and by treatment with morphine. In contrast, there was no significant change noted in numbers of parvalbumin+ neurons. However, levels of parvalbumin expression were decreased for vitamin A deficient and morphine-treated WT rats as compared to WT rats on the normal diet and placebo-treated WT rats. For TG rats, parvalbumin expression was higher for vitamin A deficient TG rats treated with either placebo or morphine than for WT vitamin A deficient rats treated with placebo, and placebo treated vitamin A deficient TG rats showed higher expression than morphine treated vitamin A deficient rats. Expression was also higher for vitamin A deficient morphine-treated rats than for the corresponding WT rat groups and for vitamin A deficient TG rats treated with placebo. For the remaining groups, parvalbumin was similar for the TG and WT rats. These findings suggest that in hippocampus vitamin A deficiency and morphine can increase parvalbumin expression, perhaps as a manifestation of a stress response. Parvalbumin-expressing GABA-ergic interneurons regulate the primary neuronal output from hippocampus that is important for memory and behavior. Therefore, these studies suggest that vitamin A deficiency and morphine might have effects that may impact such outputs and thereby have lasting effects on cognitive status.

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Section: Discussionmentioning

confidence: 99%

Effects of Vitamin A Deficiency and Opioids on Parvalbumin + Interneurons in the Hippocampus of the HIV-1 Transgenic Rat

Guo¹,

Bryant²,

Sultana³

et al. 2012

CHR

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“…risk ratio). This included studies that examined any measure of restricted food access or use, with the exception of medication-related food restrictions or instructions, or that assessed the influence of food rations or other types of food aid, with the exception of studies of micronutrient supplements as these have been summarized in another review [27] and were not considered a form of food assistance. Clinic-and community-based studies examining the influence of food insecurity or food supplementation on ART adherence were eligible for inclusion regardless of whether other outcomes (e.g.…”

Section: Study Inclusion Criteriamentioning

confidence: 99%

Does Food Insecurity Undermine Adherence to Antiretroviral Therapy? A Systematic Review

2014

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A growing body of research has identified food insecurity as a barrier to antiretroviral therapy (ART) adherence. We systematically reviewed and summarized the quantitative literature on food insecurity or food assistance and ART adherence. We identified nineteen analyses from eighteen distinct studies examining food insecurity and ART adherence. Of the thirteen studies that presented an adjusted effect estimate for the relationship between food insecurity and ART adherence, nine found a statistically significant association between food insecurity and sub-optimal ART adherence. Four studies examined the association between food assistance and ART adherence, and three found that ART adherence was significantly better among food assistance recipients than non-recipients. Across diverse populations, food insecurity is an important barrier to ART adherence, and food assistance appears to be a promising intervention strategy to improve ART adherence among persons living with HIV. Additional research is needed to determine the effectiveness and cost-effectiveness of food assistance in improving ART adherence and other clinical outcomes among people living with HIV in the era of widespread and long-term treatment.

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“…The results of the high dose multiple micronutrient supplementation trials in resource-limited settings are encouraging with benefits including improved CD4 cell count and survival among PLHIV [38,46,47]. Among HIV positive pregnant and lactating women in Tanzania, high dose multiple micronutrient supplementation also prevented adverse birth outcomes, reduced the risk of mother to child transmission, improved child growth during the first 2 years of life, and reduced child mortality in the first 2 years of life among children born to nutritionally vulnerable mothers with more advanced HIV disease [48,49].…”

Section: Nutrition Supplementation Interventions Targeted To Plhivmentioning

confidence: 99%

Food Security and Nutrition Interventions in Response to the Aids Epidemic: Assessing Global Action and Evidence

et al. 2014

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The number of people receiving antiretroviral therapy in developing countries has increased dramatically. The last decade has brought an increased understanding of the interconnectedness between HIV/AIDS, food insecurity, and undernutrition and a surge of evidence on how to address the food security and nutrition dimensions of the epidemic. We review this evidence as well as the corresponding evolution of policy support for incorporating food security and nutrition concerns into HIV programming. The available evidence, although varied in scope and methodologies, shows that nutrition supplementation and safety nets in the form of food assistance and livelihood interventions have potential in certain contexts to improve food security and nutrition outcomes in an HIV/AIDS context. In the face of funding uncertainties and competing priorities, we must maintain momentum towards effective and sustainable solutions to the epidemic through continued systematic research to inform policy and through the strengthening of monitoring systems to dynamically inform intervention development.

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Micronutrients in HIV/AIDS: is there evidence to change the WHO 2003 recommendations?

Cited by 27 publications

References 45 publications

Effects of Vitamin A Deficiency and Opioids on Parvalbumin + Interneurons in the Hippocampus of the HIV-1 Transgenic Rat

Effects of Vitamin A Deficiency and Opioids on Parvalbumin + Interneurons in the Hippocampus of the HIV-1 Transgenic Rat

Does Food Insecurity Undermine Adherence to Antiretroviral Therapy? A Systematic Review

Food Security and Nutrition Interventions in Response to the Aids Epidemic: Assessing Global Action and Evidence

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