Camp W L, Allen S, Alvarez J O, Jolly P E, Weiss H L, Phillips J F, Karita E, Serufilira A, Vermund S H
School of Public Health, University of Alabama at Birmingham, 35294-0022, USA.
J Acquir Immune Defic Syndr Hum Retrovirol. 1998 Aug 1;18(4):401-6. doi: 10.1097/00042560-199808010-00022.
Few studies have addressed the relation between serum vitamin A levels and HIV disease progression. Thirty HIV-infected women in Rwanda were studied over a time span of 26 to 99 months. Fourteen subjects seroconverted and died of HIV-related disease at a mean of 44 months (range, 26-69 months) after their first HIV-positive test and were termed "rapid progressors," (RPs). A comparison group of 16 "slow progressors" (SPs) were HIV-positive at the time of their first HIV serology and had asymptomatic HIV infections at a mean of 96 months (range, 93-99 months) after their first HIV serology. Baseline mean serum retinol values were the same in RPs and SPs: 0.65 + 0.08 micromol/L versus 0.67 + 0.09 micromol/L (p = .7). Lower serum retinol levels were observed in RPs compared with SPs for the second and third measurements, obtained at a median of 12 and 24 months past baseline: 0.51 + 0.07 micromol/L versus 0.76 + 0.14 micromol/L (p = .3) and 0.44 + 0.09 micromol/L versus 0.64 + 0.08 micromol/L (p = .08), respectively. Median retinol levels for the third sample measurement were similar in RPs with lower viral load (LVL) and SPs (0.49 micromol/L and 0.52 micromol/L, respectively) compared with only 0.19 micromol/L in RPs with higher viral load (HVL; p = .02). A trend toward decreasing serum retinol levels and increasing HIV-1 RNA viral load was observed at the third sample measurement (p = .04). Subjects with LVL, higher serum retinol levels (> or =0.70 micromol/L), or both had more favorable rates of survival than subjects with HVL, low serum retinol levels (<0.70 micromol/L), or both. Although sample size does not permit definitive conclusions, this study demonstrates an association of high HIV load, rapid progression, and low serum retinol late but not early in disease progression.
很少有研究探讨血清维生素A水平与HIV疾病进展之间的关系。在卢旺达对30名感染HIV的女性进行了为期26至99个月的研究。14名受试者发生血清转化，并在首次HIV检测呈阳性后的平均44个月（范围为26 - 69个月）死于与HIV相关的疾病，被称为“快速进展者”（RPs）。16名“缓慢进展者”（SPs）组成的对照组在首次HIV血清学检测时呈HIV阳性，在首次HIV血清学检测后的平均96个月（范围为93 - 99个月）处于无症状HIV感染状态。RPs和SPs的基线血清视黄醇平均水平相同：分别为0.65±0.08微摩尔/升和0.67±0.09微摩尔/升（p = 0.7）。在基线后中位数为12个月和24个月时进行的第二次和第三次测量中，与SPs相比，RPs的血清视黄醇水平较低：分别为0.51±0.07微摩尔/升和0.76±0.14微摩尔/升（p = 0.3）以及0.44±0.09微摩尔/升和0.64±0.08微摩尔/升（p = 0.08）。与高病毒载量（HVL）的RPs相比，低病毒载量（LVL）的RPs和SPs在第三次样本测量时的视黄醇中位数水平相似（分别为0.49微摩尔/升和0.52微摩尔/升），而HVL的RPs仅为0.19微摩尔/升（p = 0.02）。在第三次样本测量时观察到血清视黄醇水平下降和HIV - 1 RNA病毒载量增加的趋势（p = 0.04）。与HVL、低血清视黄醇水平（<0.70微摩尔/升）或两者兼有的受试者相比，LVL、血清视黄醇水平较高（≥0.70微摩尔/升）或两者兼有的受试者的生存率更高。尽管样本量不允许得出确定性结论，但本研究表明在疾病进展后期而非早期，高HIV载量、快速进展和低血清视黄醇之间存在关联。
