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(Continued
from page 2)
One study looked at the
role of vitamin A deficiencies in human immunity. The authors cited several
animal studies that induce a shift from type 2 (humoral) to type 1 (cellular)
cytokines, but could find no similar studies for humans. Controlling HIV
and Mycobacterium tuberculosis infections uses the type 1 cytokine. Investigators
studied hospitalized children in Africa where these infections and vitamin
A deficiencies are very prevalent. They found lower vitamin A levels in
children who were HIV positive than for those who were HIV negative. The
vitamin A deficient children had higher proportions of natural killer (NK)
cells and lower ratios of interleukin- 10-producing monocytes to tumor
necrosis factor alpha (TNF-a)-producing
monocytes. Vitamin A deficient children were also more
likely to have respiratory symptoms and visible BCG vaccine scarring
(Mycobacterium bovis BCG). (2)
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In the Jimenez-Exposito study,
investigators examined three groups of HIV positive patients on HAART:
1) asymptomatic, AIDS without opportunistic infections {OI’s}; 2) AIDS
with active OI’s; and 3) a control group of healthy individuals. Investigators
measured plasma levels of vitamin A, vitamin E, copper and zinc with several
inflammatory measures and found that deficiencies increased as the severity
of illness increased. They concluded that all HIV infected people (including
those who were asymptomatic) show deficiencies in micronutrients, which
get worse as the illness progresses. Jimenez-Exposito suggested however,
that plasma concentrations of micronutrients have more to do with the inflammatory
response than with nutritional status. (1)
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HIV/AIDS
WASTING
Wasting (malnutrition)
is still one of the major nutritional concerns of HIV infected people.
Not only does wasting include the loss of body fat and body mass but it
also involves the loss of micronutrients. The micronutrient loss can be
due in part to poor intake and/or severe diarrhea or other disease processes.
The person who is wasting may need vitamin and mineral supplementation,
especially vitamins A, C, E, B6, B12, and zinc. (4) Improving these deficiencies
and any others may actually improve the effectiveness of HAART, while decreasing
the rates of infections and mortality. (5, 6)
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