AIDS Treatment News #181 - Aug 20 1993
John S. James

The recent paper(1), published in the August 1993 Journal of Acquired Immune Deficiency Syndromes, is based on data from the San Francisco Men's Health Study. In 1984 this study enrolled single men, ages 25 to 50, both HIV positive and HIV negative, from the 19 census tracks in San Francisco with a high incidence of AIDS; then the men were seen every six months. They filled out a standard nutritional questionnaire, and returned it to the study before they received their first HIV test result. Therefore, the study has the advantage of representing the entire population in the AIDS-impacted areas, not just those who were ill and sought treatment. And the questionnaires were returned before participants knew their HIV status, avoiding possible bias in how they were filled out. A total of 296 men, all healthy and HIV positive, met all necessary criteria and were included in the nutrition study. Thirty six percent of them progressed to AIDS during the six years.

Special computer software analyzed the nutrition questionnaires, with peoples' reports of their dietary habits, to estimate how much of various nutrients they received from food. Those who also took nutritional supplements were asked to provide the relevant information, often directly from the labels on the bottles. After six years, the data were analyzed to see if total intake of particular nutrients was associated with a difference in the rate of progression to AIDS.

Results

The results can be confusing and hard to interpret, because often they depend on which statistical corrections were used; the researchers tried different ways. But the data seems to show that:

* With certain statistical adjustments, "The hazard of AIDS decreased as consumption increased for all 11 micronutrients [vitamin A, carotene, retinol, vitamin C, vitamin E, folic acid, riboflavin, thiamine, niacin, iron, and zinc]; this relationship was statistically significant for iron, vitamin E, and riboflavin, and approached significance for vitamin C, thiamine, and niacin." But with other ways of looking at the data, there was no statistically significant association of any of the micronutrients with AIDS.

* "Higher intake of all 11 micronutrients was associated with higher CD4 counts at baseline, and was significantly so for six of them."

* With certain statistical adjustments, those who took daily multivitamin supplements were only 70 percent as likely to progress to AIDS as those who did not.

* On the other hand, those who smoked cigarettes were significantly more likely to develop AIDS than those who did not.

However, because this study was not a randomized trial, and because of difficulties in interpreting the data, the researchers could only conclude that "the possibility that higher nutrient intakes may delay the development of AIDS cannot be ruled out."

A different limitation of the study is that it could not measure certain other potentially important nutrients, including vitamin B12, vitamin B6, and copper, because the computer software used to analyze dietary habits did not assign values for them.

Comment

During the AIDS epidemic, some physicians and nutritionists have developed nutritional-supplement recommendations for persons with AIDS or HIV. (For example, see Immune Power: A Comprehensive Healing Program for HIV, by Jon Kaiser, M. D., who has an AIDS practice in San Francisco; this book was published last month by St. Martin's Press in New York.) Since some vitamins and minerals can be dangerous in overdose, especially for persons in poor health, it is important to find out what has already been done in HIV care, before starting any high-dose regimens. It is also important to check with one's physician, because there may be particular reasons that one should not take certain nutritional supplements.

Incidentally, the median intake of the nutrients measured in the study was not especially high. A graph in the published paper showed intake levels for nine of the 11 micronutrients. Vitamin C was highest, with a median intake between eight and nine times the RDA (Recommended Daily Allowance of the U. S. Food and Drug Administration, for healthy men between ages 25 and 50 -- many suspect that the RDAs are too low for persons with HIV, because of malabsorption or for other reasons). None of the other eight nutrients even reached four times the RDA.

References

1. Abrams B., Duncan D., and Hertz-Picciotto I. A prospective study of dietary intake and acquired immune deficiency syndrome in HIV-seropositive homosexual men. JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES. August 1993; volume 6, number 8, pages 949-958.

930820
ATN18102

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 1993. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .