AEGiS-CATIE: IMMUNOMODULATORS: Can supplements of vitamins/minerals increase survival? Lessons from monkeys with AIDS

IMMUNOMODULATORS: Can supplements of vitamins/minerals increase survival? Lessons from monkeys with AIDS

TreatmentUpdate 73 - Volume 8, No 9; November 1996
Sean Hosein

As part of an experiment on nutrition, a group of researchers infected monkeys with SIV (simian immunodeficiency virus) and the animals eventually developed AIDS. These monkeys were otherwise healthy and well fed. After being infected, and despite eating an adequate diet, most of the monkeys had lower than normal levels of:

* zinc

* vitamin A

* vitamin B12

* vitamin E

* protein

So it should not be surprising that PHAs (people with HIV/AIDS) can also have low levels of these and other nutrients. This nutritional deficit could also weaken the immune system's ability to resist infections.

Study details

Researchers in the US interviewed 281 HIV-infected male volunteers (subjects) to find out about the foods they ate. Using this information , the researchers could calculate the levels of vitamins and minerals the men received from food. The study focused on the intake of the following nutrients:

* vitamins A, C and E

* some B vitamins (B1,B2,B6,B12, folic acid, niacin)

* beta-carotene

* zinc

When interviewed, researchers noted which men used vitamin/mineral supplements and proceeded to monitor them for up to 8 years.

Results: How much?

* at least 50% of subjects had high intakes of vitamins A, C, B2, B6, B12 folic acid and beta-carotene, that is, they consumed more than the recommended daily allowance of these nutrients.

* For instance, 50% of subjects received more than 37 mg/day of niacin and 25% received more than 64 mg/day.

* 50% of subjects received more than 13,000 IU/day of vitamin A (the RDA is 5,000 IU/day).

Results -- survival

Those subjects who consumed the highest levels of certain nutrients:

* 5 mg/day of B1

* 6 mg/day of B2

* 64 mg/day of niacin

* 6 mg/day of B6

* 7,622 IU/day of vitamin A

survived up to 1.3 years longer than subjects who took lower doses of those nutrients. Use of zinc supplements did not improve survival and those subjects who took zinc seemed to have reduced survival after 5 years.

Understanding the results

The results from this study do not mean that PHAs should take less vitamin B1, E and zinc and more of the other nutrients listed in the section above. All of the nutrients listed in this study are important to health. Moreover, intake of many other important nutrients were not studied:

* alpha and gamma carotenes

* pantothenic acid (a B-vitamin)

* copper, magnesium, manganese and selenium

* fatty acids found in evening primrose, fish and flax seed oil

* protein

Another important point to remember is that this study calculated the amount of nutrients consumed, not their levels in the blood.

Zinc

Zinc is an important nutrient, particularly for the immune system. Several research teams have documented decreasing levels of zinc in the blood of PHAs as the immune system weakens. A recent study found that a 45 mg/day supplement of zinc reduced the risk of developing PCP and oral fungal infections compared to subjects who did not receive extra zinc. One of the senior authors of the dietary survey study has said that he could not understand the apparent negative association of even low intake of zinc (less than 20 mg/day) in their study (personal communication, CD Myers).

Nutritional Interventions

The results from the dietary intake study support the use of nutrition supplements for PHAs, particularly B vitamins. Intestinal damage occurs in HIV and SIV infection and this may reduce absorption of nutrients, which is why high intake of some nutrients may be useful. Nutritional protocols for people with HIV/AIDS by Chester Myers, Lark Lands and Diana Davis-Kelly are available from CATIE.

REFERENCES:

1. Tang AM, Graham NMH and Saah AJ, Effect of micronutrient intake on survival in Human Immunodeficiency Virus type 1 infection. American Journal of Epidemiology 1996;143(12):1244-1256.

2. Fabris N, Mocchegiani E, Galli M, et al. AIDS, zinc deficiency, and thymic hormone failure. Journal of the American Medical Association 1988;259(6):839-840.

3. Graham NMH, Sorensen D, Odaka N, et al. Relationship of serum copper and zinc levels to HIV-1 seropositivity and progression to AIDS. Journal of Acquired Immunodeficiency Syndrome 1991;4(10):976-980.

4. Mocchegiani F, Veccia S, Ancarani F, et al. Benefit of oral zinc supplementation as an adjunct to zidovudine (AZT) therapy against opportunistic infections in AIDS. International Journal of Immunopharmacology 1995;17(9):719-727.

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Always watch for outdated information. This article first appeard in 1996. This material is designed to support, not replace, the relationship that exists between you and your doctor.

Copyright © 1996 - 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

This information is designed to support, not replace, the relationship that exists between you and your doctor.
©1996. AEGIS.