Abnormal Vitamin B12 Metabolism in Human Immunodeficiency Virus Infection

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Abstract
• An increased prevalence of vitamin B12deficiency has been reported in patients infected by the human immunodeficiency virus (HIV). We report an unexpectedly high prevalence (20%) of such abnormal vitamin B12metabolism in a population of HIV-infected patients referred for neurological evaluation. This abnormality was associated with both peripheral neuropathy and myelopathy. A majority of those treated with cyanocobalamin had a therapeutic response. Selected neuropathological results suggest a relationship between vitamin B12deficiency and vacuolar myelopathy. Vitamin B12deficiency may be a frequent and treatable cause of neurological dysfunction in patients with HIV infection.