Richard S. Beach

Specific nutrient abnormalities in asymptomatic HIV-1 infection.

ObjectiveTo determine whether specific nutrient abnormalities occur in earlier stages of HIV-1 infection, thereby preceding the marked wasting and malnutrition that accompany later stages of the infection. DesignA longitudinal investigation to determine biological, psychological and social factors thought to influence the progression and outcome of HIV-1 infection. Nutritional status was assessed using biochemical measurement of nutrient levels, dietary history, anthropometry and clinical examination for the signs and symptoms of nutritional deficiency or excess. SettingThe study was performed on an outpatient basis at the University of Miami School of Medicine. ParticipantsOne hundred homosexual men, aged between 20 and 55 years, who were asymptomatic other than persistent generalized lymphadenopathy (Centers for Disease Control stage III) and 42 age-matched homosexual men demonstrated to be free of HIV-1 infection at two 6-month intervals. Main outcome measuresBiochemical measurement of nutrient status, dietary history, anthropometry, clinical signs or symptoms of nutritional excess or deficiency were obtained for all participants. ResultsDespite few differences in mean blood levels of specific nutrients, prevalence of specific nutrient abnormalities was widespread among HIV-1-infected subjects, compared with non-infected male homosexual controls. Overtly and marginally low blood levels of vitamins A (18%), E (27%), riboflavin (26%), B6 (53%), and B12 (23%), together with copper (74%) and zinc (50%) were documented in HIV-1-seropositive subjects. With the exception of riboflavin, zinc, and copper, a similar prevalence of abnormalities among HIV-1-seronegative controls was not observed. ConclusionSpecific nutrient abnormalities occur with relative frequency in asymptomatic HIV-1 infection and may contribute to the rate and form of HIV-1 disease progression.

Selenium status and immune function in asymptomatic HIV-1 seropositive men

Abstract Altered selenium status has been shown to be associated with impairment of immune function. The present study was conducted to characterize selenium status in HIV-1 infected individuals (n=70), and determine whether alterations in selenium status were related to immune system dysregulation. Sixty-six percent of HIV-1 seropositive homosexuals, healthy other than persistent generalized lymphadenopathy, exhibited normal plasma selenium levels (85–120 μg/L). In contrast, 23% of such HIV-1 seropositive individuals had high (>120 μg/L) and 11% had low (

Nutritional knowledge, beliefs and practices in the HIV infected patient

Abstract Seventy-five HIV-seropositive, asymptomatic other than lymphadenopathy, homosexual males were studied to determine nutritional health beliefs and practices as well as general nutritional knowledge. A total of 80% of the participants reported dietary change at the time of, or subsequent to, HIV diagnosis. The most frequent dietary changes noted were decreased intake of animal products and alcohol in association with increased intake of vegetables, and seafood. The majority of participants (87%) indicated that vitamin and mineral supplements could favorably influence their immune function and thereby delay disease progression, with 59% reporting an increase in vitamins/mineral supplement consumption after HIV diagnosis. Regarding nutritional knowledge, 90% did not know the daily requirements for essential vitamins and minerals. Sources of nutritional information and counseling were most frequently provided by friends (75%) or newspapers/magazines (48%) and popular books (44%). Asymptomatic HIV-infected patients view nutritional issues as of key importance in maintaining their immune function. They frequently adopt strategies, however, based upon limited information and these strategies may at times, be ill-advised. Practitioners must work to provide the HIV-infected patient with information concerning basic nutritional needs as well as the most recent developments involving nutritional aspects of HIV infection.