|Supplements Improve Outcomes for HIV-Positive Patients|
|Tuesday, 20 July 2010 00:00|
Nutritional supplementation improves immune function and survival in HIV-infected people, according to findings presented here at AIDS 2010: XVIII International AIDS Conference.
In 3 studies conducted in the United States and Botswana, supplementation with vitamin and mineral antioxidants was associated with longer survival, less immune failure, and better mitochondrial function in CD4+ cells, Marianna K. Baum, PhD, said in a poster session. Dr. Baum, who is professor of dietetics and nutrition at Florida International University in Miami, participated in all 3 investigations.
The first 2 studies were small preliminary trials involving HIV-infected patients in Miami, about half of whom were homeless, Dr. Baum told Medscape Medical News.
They all had normal plasma albumin levels, but 50% to 65% had low levels of zinc or B vitamins, and about one third were deficient in vitamin A. About 20% of these patients also had wasting. "They may not have had frank malnutrition, but their nutritional status wasn't great," Dr. Baum said. Many of these patients obtained their meals from soup kitchens, and if they did not feel up to standing in long lines or sitting in the hot Florida sun, they might go several days without food, she noted.
In the first study, the investigators examined the effect of zinc supplementation on the prevention of immune failure in 40 HIV-positive adults on antiretroviral therapy (ART). The participants, all of whom had an undetectable viral load, were randomly assigned to receive zinc or placebo and were followed for 18 months. Immune failure was defined as a CD4 cell count below 200 cells/mm3.
Over the 18 months, 4 patients in the placebo group (21%) experienced immune failure, compared with none in the zinc group (0%; P = .043). Dr. Baum and her coauthors conclude that zinc supplementation is safe and might prevent immunologic failure in HIV-positive patients on stable ART.
HIV infection and long-term ART use increase cellular oxidative stress and might damage mitochondria, which can have implications for immune function, Dr. Baum said.