Forrester Janet E, Wang Xiang D, Knox Tamsin A, Borek Carmia G, Tang Alice M, Johnson Elizabeth J
Tufts University School of Medicine, Boston, MA, US.
J Public Health Policy. 2009 Sep;30(3):285-99. doi: 10.1057/jphp.2009.20.
The effects of hepatitis and drug use on nutritional problems in HIV infection have rarely been examined despite the importance of drug use in the global HIV pandemic. We examined the effects of HIV, hepatitis C, and drug use on serum micronutrients in 300 US Hispanic adults. Chronic hepatitis C infection was associated with lower serum retinol (-8.2 microg/dl, P < 0.0001), alpha-tocopherol (-0.10 ln microg/dl, P = 0.024), and carotenoids (-19.8 microg/dl, P < 0.0001). HIV infection was associated with lower selenium (-6.1 microg/l, P = 0.028). Elevated triglycerides in HIV infection were associated with higher serum retinol and alpha-tocopherol. Drug use was not independently associated with micronutrient alterations. We conclude that hepatitis C is an important determinant of low serum micronutrients, and should be considered in any nutritional assessment of HIV infected populations. As the safety of micronutrient supplementation is not established, policy for appropriate HIV clinical care should distinguish between populations with and without hepatitis coinfection.
尽管药物使用在全球艾滋病毒流行中具有重要意义,但肝炎和药物使用对艾滋病毒感染患者营养问题的影响却很少得到研究。我们研究了艾滋病毒、丙型肝炎和药物使用对300名美国西班牙裔成年人血清微量营养素的影响。慢性丙型肝炎感染与血清视黄醇水平降低(-8.2微克/分升,P<0.0001)、α-生育酚水平降低(-0.10 ln微克/分升,P=0.024)和类胡萝卜素水平降低(-19.8微克/分升,P<0.0001)相关。艾滋病毒感染与硒水平降低(-6.1微克/升,P=0.028)相关。艾滋病毒感染患者甘油三酯升高与血清视黄醇和α-生育酚水平升高相关。药物使用与微量营养素改变无独立相关性。我们得出结论,丙型肝炎是血清微量营养素水平低的一个重要决定因素,在对艾滋病毒感染人群进行任何营养评估时都应予以考虑。由于微量营养素补充的安全性尚未确立,适当的艾滋病毒临床护理政策应区分有无丙型肝炎合并感染的人群。