Background: Oxidative stress during HIV infection may impair immune function, cause more rapid disease progression, and increase requirements for dietary antioxidants such as vitamins C and E.
Objectives: The study had 2 principal objectives. The first was to ascertain whether HIV infection and immune activation were associated with lower plasma concentrations of ascorbate, urate, and 
– and 
-tocopherols and with total antioxidant status (TAS). The second objective was to ascertain whether these antioxidants were associated with protection against oxidative damage.
Design: This was a cross-sectional study involving 241 HIV-positive and 115 HIV-negative subjects aged 14–23 y. Subjects were primarily female (76%) and African American (70%), and 21% were Hispanic.
Results: Plasma ascorbate was significantly lower, but -tocopherol and TAS were significantly higher in subjects with HIV infection when the analysis was adjusted for dietary intake and sex. Plasma -tocopherol did not differ significantly by HIV status. Plasma -tocopherol also was higher in subjects with oxidative damage than in those without such damage. More than 90% of subjects had adequate plasma concentrations for both ascorbate and -tocopherol, although -tocopherol concentrations were lower than expected on the basis of third National Health and Nutrition Examination Survey data.
Conclusions: Low plasma ascorbate concentrations in HIV-positive subjects suggest that vitamin C requirements are significantly higher in those with HIV infection. Plasma tocopherol concentrations were not depressed by HIV infection and may be maintained by compensatory mechanisms such as the activity of -tocopherol transfer protein.
Commentary by Dr. Calapai:
HIV and its associated infections/immune dysfunctions are of the most damaging circumstances to all tissues of the human body. Progressive oxidation and deterioration can quickly devastate the immune system in many ways. Ther are thousand of studies that describe that vitamins and minerals are essential to propper immune function. I this condition there is an " accelerated need" for nutritional assesment and therapy. With common gastrointestinal issues in these patients vitamin deficiency is almost routine.
Both oral and intravenous vitamin recommendations are used to help decrease free radical damage and oxidation and to stimulate immune response.
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