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Re: [pronut-hiv] Information on B vitamins in the treatment of HIV/AIDS (2)


  • From: "George M. Carter" <fiar@verizon.net>
  • Date: Wed, 16 Aug 2006 13:44:58 -0400


B vitamins are an important part of HIV care. I think the data on the use
of a multi are compelling and it should be considered a part of the
Standard of Care for managing HIV disease. This is as applicable to people
not on ARV (and thus may act as a rationale for people to get tested
earlier) but additionally, for those on ARV to offset mitochondrial and
other toxicities.

Some abstracts below. One place to look for such information is:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

George M. Carter




*****
Singhal N, Austin J. A clinical review of micronutrients in HIV infection.
J Int Assoc Physicians AIDS Care (Chic Ill). 2002 Spring;1(2):63-75.

Ottawa Health Research Institute, Canadian HIV Trials Network, Ottawa,
Canada. nsinghal@ohri.ca

This article reviews current literature on the role of micronutrients in
human immunodeficiency virus (HIV) infection. Deficiencies of
micronutrients are common in HIV-infected persons. They occur due to
malabsorption, altered metabolism, gut infection, and altered gut barrier
function. There is a compelling association of deficiencies of
micronutrients in HIV-infection with immune deficiency, rapid disease
progression, and mortality. Also, there is increased risk of vertical HIV
transmission from mother to child with deficiency of vitamin A, and of
neurological impairment with vitamin B12. The last five years have been
exciting in micronutrient research, and there is promise that some
micronutrients may be key factors in maintaining health in HIV
immunodeficiency, and in reducing mortality. Selenium appears important in
reducing virulence of HIV and slowing disease progression. Vitamin A
supplementation in pregnant women with HIV may reduce maternal mortality
and improve birth outcomes. Supplementation in children with HIV may
accelerate growth. Carotenoid supplementation is being evaluated. Vitamin
B12 may slow HIV immune deficiency disease progression, and reverse
neurological compromise. Clinical benefit of supplementation with some
micronutrients may be measurable in the presence of pre-existing
deficiency. Apart from improved general nutrition, the impact of
micronutrient supplements on health and their optimal use in HIV infection
is controversial because there are so few controlled clinical trials.
Further research is needed to elucidate the role of micronutrient
deficiencies on the course of HIV infection, and the preventive and
therapeutic role of supplementation in its clinical management.
Nevertheless, current knowledge supports the use of routine multivitamin
and trace element supplementation as adjuvant to conventional
antiretroviral drug treatment as a relatively low-cost intervention.


****
Claessens YE, Chiche JD, Mira JP, Cariou A. Bench-to-bedside review:
severe lactic acidosis in HIV patients treated with nucleoside analogue
reverse transcriptase inhibitors. Crit Care. 2003 Jun;7(3):226-32. Epub
2003 Feb 28.

Service de Reanimation Polyvalente, Hopital Cochin and Institut Cochin,
Paris, France. yann-erick.claessens@cch.ap-hop-paris.fr

Nucleoside reverse transcriptase inhibitors (NRTIs) are effective
antiretroviral therapy for the treatment of HIV-infected patients. NRTIs
can induce mitochondrial impairment that leads to a number of adverse
events, including symptomatic lactic acidosis. In the present review, we
describe the underlying mechanism of NRTI-induced toxicity and the main
clinical features of this infrequent, but severe, emerging complication. We
also summarise experimental data and clinical observations that support the
use of L-carnitine supplementation to reverse NRTI-induced mitochondrial
impairment.

***
Day L, Shikuma C, Gerschenson M. Acetyl-L-carnitine for the treatment of
HIV lipoatrophy. Ann N Y Acad Sci. 2004 Nov;1033:139-46.

Hawaii AIDS Clinical Research Program, University of Hawaii John A Burns
School of Medicine, Honolulu, HI 96816, USA. larryd@hawaii.edu

Lipodystrophy is an increasingly recognized complication of antiretroviral
therapy for human immunodeficiency virus (HIV) infection. This syndrome
encompasses both fat accumulation and wasting, which may be accompanied by
metabolic derangements in glucose and lipid metabolism. While the precise
mechanism of its development is not fully understood, lipodystrophy may
represent chronic mitochondrial toxicity due to antiretroviral therapy
and/or chronic HIV infection. Treatment of this condition has proven
difficult, prompting research into agents that promote fat metabolism and
mitochondrial function. L-carnitine is a nonessential micronutrient that
regulates fatty acid transport into the mitochondrial matrix for metabolism
via beta-oxidation. HIV-infected individuals on antiretroviral therapy may
become deficient in this cofactor, limiting mitochondrial fat metabolism.
While studies have shown some benefit for carnitine supplementation in
cardiovascular disease, mitochondrial myopathies, and possibly male
infertility, the data for its use in HIV-infected individuals are limited.
Given its known physiologic function and the hypothesized mitochondrial
basis for lipodystrophy, carnitine supplementation for this antiretroviral
toxicity is reviewed. The available data from several small studies are
inconclusive, although further research into this promising agent is warranted.

At 11:57 AM 8/16/2006, you wrote:
>hi,
> please can someone help with information on Vitamin
>B6 or the B vitamins generally in the treatment of HIV
>/AIDS
>Emiola