Multivitamins, Nutrition, and Antiretroviral Therapy for HIV Disease in Africa

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Abstract
Readers could be forgiven for being confused by the literature on micronutrients and the pathogenesis of human immunodeficiency virus (HIV) disease. Micronutrients play important roles in maintaining immune function and neutralizing the reactive oxygen intermediates produced by activated macrophages and neutrophils in their response to microorganisms. Serum and plasma measurements of vitamins and trace elements, which are imperfect indicators of body stores, have shown that deficiencies are common among HIV-infected persons, especially those who are underprivileged, such as women in developing countries, and injection-drug users. A vicious cycle has been envisaged in which undernourished HIV-infected persons have micronutrient deficiencies, leading to further immunosuppression and oxidative stress and subsequent acceleration of HIV replication and CD4+ T-cell depletion.1