Antioxidant micronutrient intake and oxidative stress in persons with human immunodeficiency virus infection

An imbalance of the oxidant-antioxidant equilibrium has been associated with disease progression in HIV-seropositive individuals. In vitro and in vivo studies have demonstrated the efficacy of antioxidant supplementation in reducing the concentrations of oxidative stress markers. The objectives of the present cross-sectional study were to evaluate the dietary intake and nutritional supplementation practices of 24 HIV-seropositive persons in Montreal and explore the relationship between dietary intakes of antioxidant micronutrients (ascorbic acid, vitamin E, $ beta$-carotene, zinc, selenium), oxidative stress (plasma malondialdehyde (MDA), leukocyte glutathione (GSH)) and immunological indices (absolute CD4+ counts, polymorphonuclear leukocytes (PMN)). Unexpectedly, and paradoxically, a tendency to higher MDA concentrations in subjects with higher CD4+ counts was observed (r = 0.39, p $<$ 0.10). Moreover, supplementation with vitamin E was associated with significantly higher MDA concentrations (p $<$ 0.05). Ascorbic acid intake, even at levels in excess of the tissue saturation (200 mg/d) did not significantly lower MDA concentrations. Neither GSH concentrations nor CD4+ counts were significantly different between supplement users and non-users. In general, the small sample size of this study may have been in part responsible for the failure to detect statistical significance in some associations, however, trends were noted. These included the observation that vitamin supplement users were more likely to have a history of a clinical event associated with HIV infection (opportunistic infection, neoplasm, unintentional weight loss), have a longer duration of IV-seropositivity and have significantly higher MDA concentrations (p $<$ 0.05). In this study, it appears that antioxidants, and vitamin E in particular, were ineffective in reducing the elevated levels of reactive oxygen species (ROS) associated with HIV infection