Canadian AIDS Treatment Information Exchange: TreatmentUpdate 47 - Volume 4, No. 7 - February 1994
Sean Hosein

A number of studies have found that some HIV-infected people become ill faster than others. Cofactors such as drug use, age, genetics, and other infections may play a role in speeding the decline of the immune system. Another potential cofactor is nutrition. Research suggests a link between nutrition and the immune system, particularly in people with HIV/AIDS. Nutrients such as vitamins A, B-complex, C and E, beta-carotene, the amino acids carnitine, cysteine and methionine, minerals copper, selenium and zinc, protein, among other nutrients, all play a role in maintaining the health of the immune system.

WHY NUTRIENT DEFICIENCIES HAPPEN

People with HIV infection can develop nutrient deficiencies as a result of one or more of the following:

• loss of appetite
• bad eating habits
• drug use
• malabsorption
• diarrhea
• changes in energy cycles
• increased demand for nutrients because of illness
• increased demand for nutrients because of certain medicines used

Nearly 10 years ago a research project to monitor the health of men in San Francisco began. Some of the findings on nutrition have recently been released.

STUDY DETAILS

This study focused on 296 subjects and used nutrition surveys. The researchers used the HHHQ (Health Habits and History Questionnaire) developed at the National Cancer Institute, Bethesda, Maryland. This form or 'instrument' has been tested and validated before and is a useful way to find out nutritional information from research subjects. A "nutrient analysis program" was used to provide estimates of nutrients available in the food and vitamin/mineral supplements used by the subjects. As well, blood was taken at regular intervals to perform CD4+ cell counts and other lab tests.

SUBJECTS

Nearly 90% of men were white and 45% were "regular cigarette smokers" and 50% reported drinking alcohol at least three to four times per week.

RESULTS

• Those subjects who used a multivitamin supplement were 31% less likely to develop AIDS
• Subjects who had "a higher (than normal) intake of vitamins A, B1, B2 or niacin" tended to have a higher CD4+ cell count
• Those subjects who took "vitamin E and iron from food supplements alone" seemed less likely to develop AIDS than subjects who did not take these supplements.

NUTRITIONAL RESEARCH AND HIV/AIDS

It comes as no surprise that individual nutrients appear to have a protective effect on the "development of AIDS". Other researchers have found that antioxidant nutrients such as beta-carotene and vitamins C and E can enhance some activities of the immune system and have antiviral and anticancer effects in laboratory experiments. In an illness where malabsorption may be common, nutritional supplementation can play an important role in maintaining wellness and quality of life. In this context supplements of nutrients can be beneficial, as the authors of this study found.

NUTRIENTS NOT COUNTED

Although this study tracked the use of some nutrients, there were many that play an important role in health but were not measured. Thus nutrients such as vitamin B6, B12, selenium, coenzyme Q10, the amino acids carnitine, cysteine and methionine, and essential fatty acids are just some examples of nutrients not counted. This research project makes a good contribution to our knowledge about nutrition and AIDS. It is clear that many nutrients play a role in maintaining the health of the immune system and that they can delay the damage caused by HIV infection. Nutritional programmes to help the immune systems of people with HIV infection need to be developed and tested.

REFERENCES:

1. Abrams B, Duncan D and Hertz-Picciotto. A prospective study of dietary intake and Acquired Immunodeficiency Syndrome in HIV- seropositive homosexual men. J Acquir Immune Defic Syndr. 1993 Aug;6(8):949-58.

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Copyright © 1994 - TreatmentUpdate. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Editor, The Canadian AIDS Treatment Information Exchange, 555 Richmond St. West, Suite 505, Box 1104, Toronto, ON, M5V 3B1 • Phone: 416-203-7122 • Toll Free: 1-800-263-1638 • Fax: 416-203-8284  http://www.catie.ca