Low Vitamin B-12 Blood Levels Associated with Faster Progression to AIDS

A study at Johns Hopkins University, in over 300 men in the Baltimore MACS cohort (Multicenter AIDS Cohort Study), found that those with an abnormally low level of vitamin B-12 in their blood serum progressed to AIDS almost twice as fast as those with a normal level. This result was first presented as an abstract at the XI International Conference on AIDS atVancouver(1) last July, and was published in detail in the February 1997 issue of JOURNAL OF NUTRITION.(2) It was notsubmitted to the Retroviruses conference. This study was funded by two grants from the U.S. National Institutes of Health.

The study did NOT find evidence that additional vitamin B-12 serum levels (beyond that necessary to avoid a deficiency) were associated with additional benefit.

The analysis was done retrospectively, by analyzing stored serum samples after a followup period of about nine years.Therefore, it is impossible to know whether the low levels caused the faster disease progression, or occurred as a result of it; a randomized trial would be needed to be sure that correcting an abnormally low level will improve apatient's prognosis. But the researchers suspect that the low levels were causing disease progression, not vice versa, fo rvarious reasons --including the fact that the relationship was found even in the healthiest patients at least three years before development of AIDS, who presumably would have been least likely to have low blood levels as a result of the disease.

In contrast to vitamin B-12, serum levels of vitamin B-6, or offolate, were not found to correlate with disease progression in this study.

The almost two-fold increase in progression to AIDS in those with low B-12 levels was found "after adjusting for HIV-1-related symptoms, CD4+ cell count, age, serum albumin, use of antiretroviral therapy before AIDS, serum folate concentration, and frequency of alcohol consumption...Therefore, serum vitamin B-12 concentrations seem to be an early and independent marker of HIV-1 disease progression."

Note: An earlier study by the same Johns Hopkins group(3),which found greater survival associated with vitamin B-6 and several other micronutrients, was different because it estimated nutrient intake based on food questionnaires. It did not measure blood levels. (See AIDS TREATMENT NEWS issue#214, January 6, 1995).

References

1. Tang AM, Graham NMH, Chandra RK, and Saah AJ. Low serum vitamin B-12 concentrations are associated with faster human immunodeficiency virus type 1 (HIV-1) disease progression.JOURNAL OF NUTRITION. February 1997; volume 127, pages 345-351.

2. Tang AM, Graham NMH, Semba RD, Chandra RK, and Saah AJ.The role of serum micro nutrient levels in HIV-1 disease progression. XI International Conference on AIDS, Vancouver,July 7-12 [abstract #Mo.C.320].

3. Tang AM, Graham NMH, and Saah AJ. The effect of micro nutrient intake on survival in HIV-1 infection. TenthInternational Conference on AIDS, Yokohama, August 7-12, 1996[abstract PB0894].