OBJECTIVES: To determine the prevalence and describe the clinical correlates of subnormal cobalamin levels in subjects infected with the human immunodeficiency virus (HIV), and to assess its relationship to virus-mediated immunosuppression and/or anti-viral therapy. SETTING: Outpatient referral clinic in tertiary care hospital. PATIENT POPULATION: 200 HIV infected individuals. STUDY DESIGN: Descriptive cross sectional survey, with prospective follow-up in a subgroup of patients before and after initiation of zidovudine therapy. MEASURES: Routine complete blood count, serum B12 assay, CD4 counts. Serum homocysteine levels, and Schilling tests were performed on subgroups of study subjects. RESULTS: Subnormal serum B12 levels were found in 61 subjects (30.5%). B12 deficient subjects were more likely to be taking zidovudine. (P = .007). Serum homocysteine levels were significantly higher in patients with subnormal cobalamin levels but were unrelated to CD4 counts or zidovudine use, and were rarely outside of the normal range. Malabsorption of vitamin B12 as evidenced by abnormal Schilling tests was more likely among patients with more advanced HIV disease, or gastrointestinal symptoms but was not necessarily associated with low B12 levels. CONCLUSIONS: Decreased cobalamin levels are found frequently in HIV disease, especially among those treated with zidovudine. Evidence of B12 malabsorption is found among those with more advanced disease and gastrointestinal symptoms.
OBJECTIVES: To determine the prevalence and describe the clinical correlates of subnormal cobalamin levels in subjects infected with the human immunodeficiency virus (HIV), and to assess its relationship to virus-mediated immunosuppression and/or anti-viral therapy. SETTING:Outpatient referral clinic in tertiary care hospital. PATIENT POPULATION: 200 HIV infected individuals. STUDY DESIGN: Descriptive cross sectional survey, with prospective follow-up in a subgroup of patients before and after initiation of zidovudine therapy. MEASURES: Routine complete blood count, serum B12 assay, CD4 counts. Serum homocysteine levels, and Schilling tests were performed on subgroups of study subjects. RESULTS: Subnormal serum B12 levels were found in 61 subjects (30.5%). B12 deficient subjects were more likely to be taking zidovudine. (P = .007). Serum homocysteine levels were significantly higher in patients with subnormal cobalamin levels but were unrelated to CD4 counts or zidovudine use, and were rarely outside of the normal range. Malabsorption of vitamin B12 as evidenced by abnormal Schilling tests was more likely among patients with more advanced HIV disease, or gastrointestinal symptoms but was not necessarily associated with low B12 levels. CONCLUSIONS: Decreased cobalamin levels are found frequently in HIV disease, especially among those treated with zidovudine. Evidence of B12malabsorption is found among those with more advanced disease and gastrointestinal symptoms.
Authors: Valerie L Flax; Linda S Adair; Lindsay H Allen; Setarah Shahab-Ferdows; Daniela Hampel; Charles S Chasela; Gerald Tegha; Eric J Daza; Amanda Corbett; Nicole L Davis; Deborah Kamwendo; Athena P Kourtis; Charles M van der Horst; Denise J Jamieson; Margaret E Bentley Journal: J Nutr Date: 2015-07-08 Impact factor: 4.798
Authors: Lindsay H Allen; Daniela Hampel; Setareh Shahab-Ferdows; Emily R York; Linda S Adair; Valerie L Flax; Gerald Tegha; Charles S Chasela; Debbie Kamwendo; Denise J Jamieson; Margaret E Bentley Journal: Am J Clin Nutr Date: 2015-11-04 Impact factor: 7.045
Authors: Aggrey S Semeere; Damalie Nakanjako; Henry Ddungu; Andrew Kambugu; Yukari C Manabe; Robert Colebunders Journal: PLoS One Date: 2012-07-02 Impact factor: 3.240
Authors: Daniela Hampel; Setareh Shahab-Ferdows; Erik Gertz; Valerie L Flax; Linda S Adair; Margaret E Bentley; Denise J Jamieson; Gerald Tegha; Charles S Chasela; Debbie Kamwendo; Charles M van der Horst; Lindsay H Allen Journal: Matern Child Nutr Date: 2017-08-29 Impact factor: 3.092