Dietary Micronutrient Intake and Risk of Progression to Acquired Immunodeficiency Syndrome (AIDS) in Human Immunodeficiency Virus Type 1 (HlV-1)-infected Homosexual Men

Abstract

The authors sought to determine if different levels of dietary intake of micronutrients are associated with the progression of human immunodeficiency virus type 1 (HIV-1) infection to acquired immunodeficiency syndrome (AIDS). A total of 281 HIV-1 seropositive homosexual/bisexual men were seen semiannually since 1984 at the Baltimore/Washington, DC site of the Multicenter AIDS Cohort Study. Participants completed a self-administered semiquantitative food frequency questionnaire at baseline. Levels of daily micronutrient intake at baseline were examined in relation to subsequent progression to AIDS (1987 Centers for Disease Control definition; n = 108) during a median follow-up period of 6.8 years. For each nutrient, the authors used a Cox proportional hazards model to adjust for age, presence of symptoms, CD4+ lymphocyte count, energy intake, use of antiretrovirals, and use of Pneumocystis carinii pneumonia prophylaxis. The highest levels of total intake (from food and supplements) of vitamins C and B1 and niacin were associated with a significantly decreased progression rate to AIDS: vitamin C (relative hazard (RH) = 0.55, 95% confidence interval (CI) 0.34-0.91), vitamin B1 (RH = 0.60, 95% CI 0.36-0.98), and niacin (RH = 0.52, 95% CI 0.31-0.86). The relation between total vitamin A intake and progression to AIDS appeared to be U-shaped; the lowest and highest quartiles of intake did most poorly, while the middle two quartiles were associated with significantly slower progression to AIDS (RH = 0.55, 95% CI 0.35-0.88). Increased intake of zinc was monotonically and significantly associated with an increased risk of progression to AIDS (for highest vs. lowest quartiles, RH = 2.06, 95% CI 1.16-3.64). In a final multinutrient model, vitamin A, niacin, and zinc remained significantly associated with progression to AIDS, while vitamin C was only marginally significant.

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

“…Previous observational studies found that dietary zinc intake above the recommended dietary allowance (RDA) among HIV-infected persons was related to rapid progression to AIDS (Tang et al, 1993) and mortality (Tang et al, 1996). In contrast, in a randomized, nonplacebo controlled study of HIV-positive Italian adults who were receiving zidovudine, daily supplementation with three to four times the RDA (45.5 mg zinc) for 1 month appeared to prevent weight loss in patients of advanced stage at baseline, and increased CD4 cell counts after 4 months (Mocchegiani et al, 1995).…”

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

“…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).…”

“…No recommended daily allowance or tolerable upper intake level has been set for carotenoids (Institute of Medicine, 2000), and they are safe with long-term use (Mathews-Roth, 1986). Anecdotal adverse effects of b-carotene supplementation (Mathews-Roth, 1986), a possible adverse effect in smokers and in those with asbestos exposure (The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group, 1994;Hennekens et al, 1996;Omenn et al, 1996), and the association of HIV disease acceleration and death with high b-carotene intake in an observational study (Tang et al, 1993(Tang et al, , 1996 remain to be confirmed in randomized clinical trials.…”

Antioxidant Status in Hiv/Aids Adolescent Patients of Manipur.

“…Infections may also affect the absorption, tissue distribution and excretion of nutrients [4]. It is thus not surprising that a low intake of vitamin C, low plasma concentrations of vitamin E and reduced serum glutathione level have been associated with a greater risk of progression into AIDS in HIV infected subjects and can also be correlated with a poor survival in AIDS patients [5,6,7].…”