Urinary excretion and plasma vitamin E levels in patients with AIDS

Individuals with acquired immunodeficiency virus (HIV) and patients with acquired immunodeficiency syndrome (AIDS) present a variety of pathologic alterations that influence their nutritional status during various stages of the disease. Previous studies have reported a reduction in plasma vitamin E levels in these patients associated with a higher production of free radicals. Individuals with infection, fever, or acute diarrhea excrete considerable amounts of vitamin A in urine. This observation raised the hypothesis that this may also be the case for vitamin E and that its urinary excretion may play a significant role in the reduction of plasma vitamin E levels. In the present investigation, 28 serologically positive HIV-1 (HIV group) divided into a group of 16 patients with AIDS (< 200/mm(3) CD4(+) T lymphocytes) were studied. The control group consisted of 11 healthy individuals. Urinary and plasma vitamin E levels were determined by high-performance liquid chromatography. Patients with AIDS presented reduced plasma vitamin E levels (15.25 +/- 12.19 mu mol/L) compared with the HN (26.40 +/- 17.01 mu mol/L) and control (40.03 +/- 31.80 mu mol/L) groups. On the other hand, urinary excretion was higher in the AIDS group (0.86 +/- 0.99 mu mol/24 h) than in the HIV group (0.62 +/- 0.46 mu mol/24 h) and considerably higher than in the control group (0.05 +/- 0.13 mu mol/24 h). These results indicate elevated vitamin E excretion in the urine of both patients with AIDS and patients with HIV-1, leading to a reduction in the plasma level of this vitamin. Therefore, systematic monitoring of plasma and urinary vitamin E levels is recommended for patients with HIV and patients with AIDS and, if necessary, the combination of existing medical therapy with vitamin supplementation to maintain the nutritional status related to vitamin E. (C) Elsevier Science Inc. 1998.