Submitted to: American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/3/2006
Publication Date: 1/31/2006
Citation: Stephensen, C.B., Marquies, G.S., Jacob, R.A., Kruzich, L.A., Douglas, S.D., Wilson, C.M. 2006. Vitamins c and e in adolescents and young adults with hiv infection. American Journal of Clinical Nutrition. 2006. 83:870-879. Interpretive Summary: In the current observational study, we examined the relation of vitamin C and E intakes, HIV status, and immune activation to biochemical indicators of antioxidant status, including plasma alpha-tocopherol, gamma-tocopherol, ascorbate, and urate concentrations and total antioxidant status (TAS). In turn, we assessed the association of these variables with indicators of oxidative damage (ie, plasma malondialdehyde and protein carbonyl concentrations). Our goals were to assess the antioxidant status of these subjects, ascertain whether HIV infection was associated with lower plasma concentrations of these key antioxidant nutrients, identify markers of immune activation that may be associated with low plasma concentrations of these nutrients (and, by inference, with greater utilization), and ascertain whether plasma concentrations of these nutrients were associated with protection against oxidative damage (ie, lower concentrations of plasma oxidative damage markers).
Technical Abstract: Background: Oxidative stress during HIV infection may impair immune function, cause rapid disease progression, and increase requirements for dietary antioxidants such as vitamins C and E. Objective: The study had 2 principal objectives. The first was to ascertain whether HIV infection and immune activation were associated with lower plasma concentrations of ascorbate, urate, and alpha and gamma-tocopherols and with total antioxidant status (TAS). The second objective was to ascertain whether these antioxidants were associated with protection against oxidative damage. Design: This was a cross-sectional study involving 241 HIV-positive and 115 HIV-negative subjects 14-23 y. Subjects were primarily female (76%) and African American (70%), and 21% were Hispanic. Results: Plasma ascorbate was significantly lower, but gamma-tocopherol and TAS were significantly higher in subjects with HIV infection when analysis was adjusted for dietary intake and sex. Plasma alpha-tocopherol did not differ significantly by HIV status. Plasma gamma-tocopherol also was higher in subjects with oxidative damage than in those without such damage. More than 90% of subjects had adequate plasma concentrations for both ascorbate and alpha-tocopherol, although gamma-tocopherol concentrations were lower than expected on the basis of third National Health and Nutrition Examination Survey data. Conclusions: Low plasma ascorbate concentrations in HIV-positive subjects suggest that vitamin C requirements are significantly higher in those with HIV infection. Plasma tocopherol concentrations were not depressed by HIV infection and may be maintained by compensatory mechanisms such as the activity of alpha-tocopherol transfer protein.