Abstract
Objective: Large epidemiological studies have linked decreased concentrations of carotenoids to increased risk for precan-cerous and cancerous lesions and immune dysfunction. Given this possible link between carotenoids and disease risk, we measured serum carotenoids, Vitamin A and Vitamin E in patients at different stages of HIV infection to see if these micronutrients were affected by advanced disease.
Methods: Serum from 57 patients, including 18 patients with < 200 CD4 cells/mm3, 26 patients with 200-500 CD4 cells/mm3, 12 patients with > 500 CD4 cells/mm3, and 27 HIV seronegative controls was evaluated for concentrations of beta carotene, alpha carotene, lutein, lycopene, beta cryptoxanthin, Vitamin A, gamma toco-pherol and Vitamin E.
Results: HIV infected patients at all stages of disease have significantly decreased concentrations of beta carotene, alpha carotene and beta cryptoxanthin compared to seronegative controls. Carotenoid levels were lowest in patients with CD4 < 200 cells/mm3. Vitamins A and E did not differ significantly between any of the groups studied.
Discussion: HIV infection is associated with decreased serum carotenoid concentrations.
A variety of studies have suggested that low serum beta carotene and/or vitamin A levels were associated with an increased risk for a number of diseases, including cancers such as lung cancer, stomach cancer, breast cancer, precancerous lesions and heart disease.1-7 Previous studies have also suggested that beta carotene and/or vitamin A supplementation can increase immune function both in vivo and in vitro.8-15
It also appears that deficiencies of micronutrients commonly occurs in HIV infection and AIDS.16-20 These deficiencies are associated with further immune dysfunction in HIV infected pa-tients.16 Moreover, supplementation may enhance immune function in these patients.8,16 We recently demonstrated that supplementation with 180 mg per day of beta carotene increased the number of T helper lymphocytes, and total white blood cells and the helper/suppressor cell ratio compared to placebo in HIV infected patients.8
Several gaps remain in our knowledge about the role of beta carotene and other carotenoids in HIV infection. No measurements of beta carotene have been reported in this population. As such, it is unclear if low levels or frank deficiencies of beta carotene and the other carotenoids are common or not in HIV infected patients, and whether there is any association with the degree of immune dysfunction. In this study, we measured carotenoids and Vitamin A and E in HIV infected patients at various stages of disease as well as in a control group to see if there was any correlation between specific carotenoids or vitamin A or E and the degree of immune deficiency.