HIV/AIDS Diet & Nutrition: HIV-1-infected patients need higher retinol doses to compensate for urinary loss

AIDSWEEKLY Plus; Monday, July 3, 2006
Staff Medical Writers

According to a recently published study from Brazil, "Retinol deficiency is quite frequent in the population of human immunodeficiency virus (HIV)-infected individuals. Serum retinol levels of less than 1.05 mc mol/L determine a 3.5 to 5 times higher death risk.

"However, studies evaluating the efficacy of retinol supplementation in HIV-seropositive individuals have reported conflicting results. The World Health Organization recommends the treatment of vitamin A deficiency in seropositive individuals in the same manner as for seronegative individuals, but clinical studies proving the efficacy of this scheme are lacking."

"The proposal of the present study was to assess the efficacy of supplementation with high retinol doses in HIV-infected patients with vitamin A deficiency. Twenty-five adult HIV-seropositive individuals were monitored over a period of 9 months, with determination of serum and urinary retinol every 3 months.

"The subjects received retinol palmitate doses ranging from 300,000 IU to 600,000 IU. Patients whose retinol levels were higher than 1.60 mcM/L were only observed. Eighteen patients received supplementation during clinical monitoring. wrote F.F. Neves and colleagues at the University of Sao Paulo in Ribeirao Preto.

"The dose of 600,000 IU induced a significant mean increase in serum levels of 0.47 mcM/L (p=0.049) within a period of 3 months. Those who received 300,000 IU presented a mean increase of 0.29 mcM/L," investigators reported.

"In contrast," continued Neves, "the patients who did not receive replacement therapy presented a significant decrease (p=0.017) in serum retinol levels, with initial and final values of 1.77 mcM/L and 1.55 mcM/L.

"The individuals with the worst response to supplementation presented a higher urinary loss of retinol at the beginning of the study. Even with a mean retinol supplementation of 771,428 IU during the study period, six patients had marginal serum retinol levels at the end of the study."

The authors concluded that in "view of the high urinary loss of this nutrient, there is the need to redefine the ideal dose for the treatment of HIV-infected individuals."

Neves and colleagues published their study in Nutrition (Recommended dose for repair of serum vitamin A levels in patients with HIV infection/AIDS may be insufficient because of high urinary losses. Nutrition. 2006 May;22(5):483-9).

For more information, contact F.F. Neves, University of Sao Paulo, Faculty of Medicine Ribeirao Preto, Dept. Internal Medicine, Division Infection & Tropical Disease, Ribeirao Preto, Brazil.

Publisher contact information for the journal Nutrition is: Elsevier Science Inc., 360 Park Avenue South, New York, NY 10010-1710, USA.

Keywords: Ribeirao Preto, Brazil, HIV/AIDS, Serum Retinol, Urinary Loss, Dietary Vitamin A, High Dosage.

This article was prepared by AIDS Weekly editors from staff and other reports.

Reference

Neves FF, Vannucchi H, Jordao AA Jr, et al., “Recommended dose for repair of serum vitamin A levels in patients with HIV infection/AIDS may be insufficient because of high urinary losses”, Nutrition. 2006 May;22(5):483-9.

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