Prior to highly active antiretroviral therapy (HAART) 20% of HIV-infected patients had low vitamin B-12 concentrations. In addition, 10% had low red blood cell folate (RBCF) concentrations. However, few patients had real vitamin B-12 deficiency.
In this study, researchers evaluated the prevalence of low vitamin B-12 and RBCF concentrations in HIV-infected patients receiving HAART. The team also assessed the usefulness of serum homocysteine (sHcy) for differentiating patients with deficiency, from those with harmlessly low vitamin B-12.
The team’s findings are published in the February issue of the American Journal of Clinical Nutrition.
| Prevalence of low vitamin B-12 lower in patients receiving HAART.|
|American Journal of Clinical Nutrition|
The researchers evaluated the prevalence of low vitamin B-12 and RBCF in 126 HIV-infected patients receiving HAART.
In addition, sHcy concentrations were evaluated in 40 HIV-infected patients with low vitamin B-12 and in 37 HIV-infected patients with low RBCF. These were compared with those in 128 HIV-infected patients with normal vitamin B-12 and RBCF.
The team also used sHcy to monitor treatment with vitamin B-12 and folic acid in 28 patients.
The research team found that the prevalence of low vitamin B-12 was lower in patients receiving HAART, than in patients who did not receive HAART (9% compared with 27%).
Of the 40 patients with low vitamin B-12 (≤200 pmol/l), 9 were found to have hyperhomocysteinemia (> 17.5 µmol homocysteine/l).
Furthermore, of the 37 patients with low RBCF (≤580 nmol/l), 19 had hyperhomocysteinemia.
Of the 9 patients with an RBCF concentration ≤450 nmol/l, all had hyperhomocysteinemia.
The team found that treatment with vitamin B-12 and folic acid normalized sHcy concentrations.
Dr Angel Remacha’s team concluded, “The prevalence of low vitamin B-12 decreased after the introduction of HAART”.
“The study of sHcy is useful for detecting HIV-infected patients with low vitamin B-12 and real deficiency.”