Micronutrients and HIV

[Guest guest]

Wed, 15 Jun 2005 21:25:42 -0000

" califpacific " <califpacific

Micronutrients: Current Issues for HIV Care

Providers -

Article in Medscap

 

Wed, 15 Jun 2005 19:52:10 +0200

" Sepp Hasslberger " <sepp

Micronutrients: Current Issues for HIV Care

Providers -

Article in Medscap

 

 

Perhaps, ever so slowly, the question of nutrition

being an integral

part of any anti Aids strategy, is sinking into the

medical

mainstream...

 

Kind regards

Sepp

 

 

 

Micronutrients: Current Issues for HIV Care Providers

 

<http://mp.medscape.com/cgi-bin1/DM/y/epsn0Fkieu0Dys0GgJv0Ec>http://mp.medscape.\

com/cgi-bin1/DM/y/epsn0Fkieu0Dys0GgJv0Ec

 

Conclusions

 

Micronutrients play a critical role in the maintenance

of immune

function (including mucosal immunity) and overall

metabolism. With

the complexity of HIV infection and treatment, and the

pace of

clinical research, it is not surprising that

sophisticated studies of

the role of micronutrients in HIV have lagged somewhat

behind other

areas of inquiry. Much credit is due to researchers

who have been

asking, and continue to ask, questions about

micronutrient status and

the progression of HIV infection. As HIV becomes a

more chronic,

manageable disease, and treatment becomes available to

more of those

infected throughout the world, it may be possible to

begin to more

precisely define the areas in which micronutrients may

help to

maximize the clinical status of HIV-infected patients.

Studies to

date reveal that this is a complex topic, fraught with

pitfalls. For

example, it is difficult to ascertain true

micronutrient status,

measures of intake are imprecise, recommendations for

desired intakes

vary, and surrogate markers of oxidative stress may

not be

reproducible.

<http://www.medscape.com/viewarticle/505659_Tables#T4>Table

4

summarizes some of the outstanding questions that

remain in this area

of research.

 

As more HIV infected individuals around the world are

initiated on

effective anti-HIV therapy, the need to maximize

durability of viral

suppression will become increasingly important. Data

are needed on

the role that micronutrient status may play on

low-level viral

replication among subjects on therapy. For

HIV-infected individuals

with adequate viral suppression, but inadequate CD4+

cell counts,

micronutrients could play a role in boosting the

immune response.

 

As HIV-infected individuals co-exist with chronic

viral infection and

chronic antiretroviral therapy, the need to examine

creative

interventions to minimize long-term complications such

as fat

atrophy, insulin resistance, lipid abnormalities are

becoming

increasingly important. The role that micronutrients,

particularly

the antioxidants, may play in modulating these

toxicities is not yet

clear and should be studied. In addition, for the

patient with

multiple chronic viral infections, such as HIV and

hepatitis B and/or

C, micronutrient supplementation may also be

beneficial in minimizing

the co-morbidities associated with these

co-infections. As the

HIV-infected population ages, and the risk of

cardiovascular disease

increases, antioxidants may again play a role in

diminishing

progression of such disease. There is also some

evidence for the role

of antioxidants in modulating subtle cognitive defects

in HIV and

this area needs further study as well.[109]

 

Research is also needed to address the appropriate

dosages of

micronutrient supplementation among HIV-infected

individuals at

various stages of disease and treatment. Little

consistency has been

found in the studies done to date on dose or duration

of

administrations, making comparisons between studies

and

interpretations of results difficult.

 

The intention of clinicians and clinical researchers

in HIV in 2005

should be to maximize the quality and duration of

survival for

HIV-infected individuals throughout the world. This

objective could

entail the study and use of interventions, such as

micronutrients,

that may not be part of the traditional care or

thought process of

the HIV care provider. Attempts to improve dietary

quality and

micronutrient status may play an overall role in

maximizing health

for the HIV-infected individual, particularly in

undernourished

populations, and may also play a role in the more

subtle management

of HIV infection in the future.

 

Funding Information

 

Sponsorship: This study was supported by: 1P01D45734,

1K24AI055293,

1P30DA13868, and 1P30A142853, 1R01DA14501 and

1R01DA11598

 

 

 

 

 

--

 

 

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intuition.

 

Sepp Hasslberger

 

 

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