AIDS Research
Effects of micronutrient intake on survival in human immunodeficiency
virus type 1 infection.
Am J Epidemiol 1996 Jun 15;143(12):1244-56 (ISSN: 0002-9262)
Tang AM; Graham NM; Saah AJ Department of Epidemiology, Johns
Hopkins University, School of Hygiene and Public Health, Baltimore, MD,
USA.
The authors examined the relation between dietary and supplemental micronutrient
intake and subsequent mortality among 281 human immunodeficiency type
1 (HIV-1)-infected participants at the Baltimore, Maryland/Washington,
DC, site of the Multicenter Acquired Immunodeficiency Syndrome Cohort
Study. Subjects completed a semiquantitative food frequency questionnaire
at their baseline visit in 1984. Levels of daily micronutrient intake
were examined in relation to subsequent mortality over the 8-year follow-up
period by using multivariate Cox models, adjusting for age, symptoms,
CD4+ count, energy intake, and treatment. The highest quartile of intake
for each B-group vitamin was independently associated with improved survival:
B1 (relative hazard (RH) = 0.60, 95% confidence interval (CI) 0.38-0.95),
B2 (RH = 0.59, 95% CI 0.38-0.93), B6 (RH = 0.45, 95% CI 0.28-0.73), and
niacin (RH = 0.57, 95% CI 0.36-0.91). In a final model, the third quartile
of beta-carotene intake (RH = 0.60, 95% CI 0.37-0.98) was associated with
improved survival, while increasing intakes of zinc were associated with
poorer survival. Intakes of B6 supplements at more than twice the recommended
dietary allowance were associated with improved survival (RH = 0.60, 95%
CI 0.39-0.93), while intakes of B1 and B2 supplements at levels greater
than five times the recommended dietary allowance were associated with
improved survival (B1: RH = 0.61, 95% CI 0.38-0.98; B2:RH = 0.60, 95%
CI 0.37-0.97). Any intake of zinc supplements, however, was associated
with poorer survival (RH = 1.49, 95% CI 1.02-2.18). These data support
the performance of clinical trials to assess the effects of B-group vitamin
supplements on HIV-1-related survival. Further studies are needed to determine
the optimal level of zinc intake in HIV-1-infected individuals.
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