Document Detail


Micronutrients in HIV-positive persons receiving highly active antiretroviral therapy.
MedLine Citation:
PMID:  17284727     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In HIV-infected persons, low serum concentrations of vitamins and minerals, termed micronutrients, are associated with an increased risk of HIV disease progression and mortality. Micronutrient supplements can delay HIV disease progression and reduce mortality in HIV-positive persons not receiving highly active antiretroviral therapy (HAART). With the transition to more universal access to HAART, a better understanding of micronutrient deficiencies and the role of micronutrient supplements in HIV-positive persons receiving HAART has become a priority. The provision of simple, inexpensive micronutrient supplements as an adjunct to HAART may have several cellular and clinical benefits, such as a reduction in mitochondrial toxicity and oxidative stress and an improvement in immune reconstitution. We reviewed observational and trial evidence on micronutrients in HIV-positive persons receiving HAART to summarize the current literature and suggest future research priorities. A small number of observational studies have suggested that some, but not all, micronutrients may become replete after HAART initiation, and few intervention studies have found that certain micronutrients may be a beneficial adjunct to HAART. However, most of these studies had some major limitations, including a small sample size, a short duration of follow-up, a lack of adjustment for inflammatory markers, and an inadequate assessment of HIV-related outcomes. Therefore, few data are available to determine whether HAART ameliorates micronutrient deficiencies or to recommend or refute the benefit of providing micronutrient supplements to HIV-positive persons receiving HAART. Because micronutrient supplementation may cause harm, randomized placebo-controlled trials are needed. Future research should determine whether HAART initiation restores micronutrient concentrations, independent of inflammatory markers, and whether micronutrient supplements affect HIV-related outcomes in HIV-positive persons receiving HAART.
Authors:
Paul K Drain; Roland Kupka; Ferdinand Mugusi; Wafaie W Fawzi
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Review    
Journal Detail:
Title:  The American journal of clinical nutrition     Volume:  85     ISSN:  0002-9165     ISO Abbreviation:  Am. J. Clin. Nutr.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-02-07     Completed Date:  2007-03-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376027     Medline TA:  Am J Clin Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  333-45     Citation Subset:  AIM; IM    
Affiliation:
University of Washington School of Medicine, Seattle, WA 98195, USA. pkdrain@u.washington.edu
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MeSH Terms
Descriptor/Qualifier:
Anti-HIV Agents / therapeutic use*
Antiretroviral Therapy, Highly Active*
HIV Infections / blood*,  drug therapy*,  metabolism
HIV Seropositivity / blood,  drug therapy
Humans
Micronutrients / blood*,  metabolism
Chemical
Reg. No./Substance:
0/Anti-HIV Agents; 0/Micronutrients

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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