Eshetu Amare, Tsegaye Aster, Petros Beyene
Department of Biology, Wollo University, P.O. Box 1145, Dessie, Ethiopia,
Biol Trace Elem Res. 2014 Dec;162(1-3):106-12. doi: 10.1007/s12011-014-0095-4. Epub 2014 Sep 26.
Poor micronutrient levels are associated with an increased risk of progression to AIDS and are also suggested to influence outcome of highly active antiretroviral therapy (HAART), though existing data are inconclusive to support the latter. Few published data are available on micronutrient levels in Ethiopian HIV/AIDS patients taking HAART. The objective of the study was to determine the association of micronutrient levels and response to HAART (CD4(+) T cell count) among adult HIV/AIDS patients attending a teaching Hospital in Addis Ababa. CD4(+) T cell counts and micronutrient (retinol, zinc, and iron) levels for 171 subjects were determined using standard procedures. Some proportions of the study participants were found deficient for retinol (14.03 %), zinc (47.3 %), and iron (2.8 %). Patients who were deficient in retinol had a significantly lower median CD4(+) T cell counts (P = 0.002) compared to non-deficient subjects. Association of micronutrient quartiles with CD4+ T cell count was assessed using adjusted multivariate regression by taking quartile 4 as a reference category. Accordingly, patients who had retinol levels in quartile 4 had a significantly lower mean CD4(+) T cell count compared to quartile 3 (P = 0.02). The significantly higher CD4(+) T cell counts in patients who were non-deficient in retinol imply the role of retinol in improving the production of CD4(+) T cells. However, both lower and higher retinol levels were associated with suppressed immunity (CD4 < 200 cells/mm(3)), suggesting an adverse effect of higher retinol levels. Thus, retinol may be potentially harmful depending on the dose, emphasizing the need for optimized level of retinol in nutrient supplements in patients taking HAART.
微量营养素水平低下与艾滋病进展风险增加相关，并且也有人认为其会影响高效抗逆转录病毒疗法（HAART）的疗效，尽管现有数据尚无定论来支持后者。关于接受HAART治疗的埃塞俄比亚艾滋病毒/艾滋病患者的微量营养素水平，鲜有公开数据。本研究的目的是确定亚的斯亚贝巴一家教学医院的成年艾滋病毒/艾滋病患者中微量营养素水平与HAART反应（CD4(+) T细胞计数）之间的关联。采用标准程序测定了171名受试者的CD4(+) T细胞计数和微量营养素（视黄醇、锌和铁）水平。研究参与者中发现有一定比例的人缺乏视黄醇（14.03%）、锌（47.3%）和铁（2.8%）。与非缺乏视黄醇的受试者相比，缺乏视黄醇的患者的CD4(+) T细胞计数中位数显著更低（P = 0.002）。以第4四分位数为参照类别，通过调整后的多变量回归评估微量营养素四分位数与CD4+ T细胞计数之间的关联。因此，与第3四分位数相比，视黄醇水平处于第4四分位数的患者的平均CD4(+) T细胞计数显著更低（P = 0.02）。视黄醇不缺乏的患者中CD4(+) T细胞计数显著更高，这意味着视黄醇在改善CD4(+) T细胞生成方面的作用。然而，视黄醇水平较低和较高均与免疫抑制（CD4＜200个细胞/mm(3)）相关，表明视黄醇水平较高存在不良影响。因此，视黄醇可能根据剂量具有潜在危害，这凸显了在接受HAART治疗的患者的营养补充剂中优化视黄醇水平的必要性。
