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Article Dans Une Revue European Journal of Clinical Microbiology & Infectious Diseases Année : 2020

Hypervitaminosis a is associated with immunological non-response in hiv-1-infected adults: a case-control study

Résumé

For people living with HIV, determinants of immunological non-response (INR) to combined antiretroviral therapy (cART) have not been fully elucidated. In a case-control study, we evaluated the influence of the nutritional and antioxidant status in HIV-1 adults whose cART was initiated between January 2001 and December 2013. Cases had persistent CD4 counts < 350/μL vs. > 350/μL for controls, after at least 2 years of cART with persistent viral loads (VL) < 50 copies/mL. Twelve cases and twenty-eight control subjects with the same CD4 count at cART initiation were compared for their nutritional and antioxidant status after age adjustment at dosage assessment. Patients were predominantly male (70%), Caucasian (82%) and at AIDS stage (62%). The median age was 53, and the median CD4 count was 245/mm3 for cases and 630/mm3 for controls after a median time of 7 years on cART. Despite higher energy intakes in cases, anthropometric data was comparable between groups who had similar vitamins B9/B12/C/D/E, zinc, citrulline and glutamine levels. Nine cases (75%) and 8 controls (29%) had hypervitaminosis A (> 2.70 μmol/L) (p = 0.030). Cases had lower erythrocyte resistance when exposed to a controlled free radical attack (p = 0.014). Most cases had hypervitaminosis A and altered antioxidant capacities that could affect immunological response. Wide-scale studies are required, but in the meantime, screening of their vitamin A status must be encouraged in these patients.
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Dates et versions

hal-04384412 , version 1 (10-01-2024)

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Hugues Melliez, Michel Prost, Helene Behal, Nathalie Neveux, Jean-Francois Benoist, et al.. Hypervitaminosis a is associated with immunological non-response in hiv-1-infected adults: a case-control study. European Journal of Clinical Microbiology & Infectious Diseases, 2020, European Journal of Clinical Microbiology & Infectious Diseases, 39, pp.2091-2098. ⟨10.1007/s10096-020-03954-0⟩. ⟨hal-04384412⟩
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