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Vitamins C and E in adolescents and young adults with HIV infection ^1,2,3

¹ From the US Department of Agriculture Agricultural Research Service, Western Human Nutrition Research Center at the University of California, Davis, Davis, CA (CBS and RAJ); the Department of Nutrition, University of California, Davis, CA (CBS and RAJ); the Department of Food Science and Human Nutrition, Iowa State University, Ames, IA (GSM and LAK); the Division of Allergy and Immunology, Joseph Stokes Jr Research Institute at The Children's Hospital of Pennsylvania, Philadelphia, PA (SDD); the Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, PA (SDD); and the Department of Pediatrics and Medicine, University of Alabama at Birmingham, Birmingham, AL (CMW)

Background: Oxidative stress during HIV infection may impair immune function, cause more rapid disease progression, and increase requirements for dietary antioxidants such as vitamins C and E.

Objectives: The study had 2 principal objectives. The first was to ascertain whether HIV infection and immune activation were associated with lower plasma concentrations of ascorbate, urate, and - and -tocopherols and with total antioxidant status (TAS). The second objective was to ascertain whether these antioxidants were associated with protection against oxidative damage.

Design: This was a cross-sectional study involving 241 HIV-positive and 115 HIV-negative subjects aged 14–23 y. Subjects were primarily female (76%) and African American (70%), and 21% were Hispanic.

Results: Plasma ascorbate was significantly lower, but -tocopherol and TAS were significantly higher in subjects with HIV infection when the analysis was adjusted for dietary intake and sex. Plasma -tocopherol did not differ significantly by HIV status. Plasma -tocopherol also was higher in subjects with oxidative damage than in those without such damage. More than 90% of subjects had adequate plasma concentrations for both ascorbate and -tocopherol, although -tocopherol concentrations were lower than expected on the basis of third National Health and Nutrition Examination Survey data.

Conclusions: Low plasma ascorbate concentrations in HIV-positive subjects suggest that vitamin C requirements are significantly higher in those with HIV infection. Plasma tocopherol concentrations were not depressed by HIV infection and may be maintained by compensatory mechanisms such as the activity of -tocopherol transfer protein.

Key Words: Antioxidants • -tocopherol • -tocopherol • ascorbate • oxidative damage

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