This article reviews current literature on the role of
micronutrients in human immunodeficiency virus (
HIV) infection. Deficiencies of
micronutrients are common in HIV-infected persons. They occur due to malabsorption, altered metabolism, gut
infection, and altered gut barrier function. There is a compelling association of deficiencies of
micronutrients in
HIV-infection with immune deficiency, rapid
disease progression, and mortality. Also, there is increased risk of vertical HIV transmission from mother to child with deficiency of
vitamin A, and of neurological impairment with
vitamin B12. The last five years have been exciting in
micronutrient research, and there is promise that some
micronutrients may be key factors in maintaining health in HIV immunodeficiency, and in reducing mortality.
Selenium appears important in reducing virulence of HIV and slowing
disease progression.
Vitamin A supplementation in pregnant women with HIV may reduce maternal mortality and improve birth outcomes. Supplementation in children with HIV may accelerate growth.
Carotenoid supplementation is being evaluated.
Vitamin B12 may slow HIV
immune deficiency disease progression, and reverse neurological compromise. Clinical benefit of supplementation with some
micronutrients may be measurable in the presence of pre-existing deficiency. Apart from improved general nutrition, the impact of
micronutrient supplements on health and their optimal use in
HIV infection is controversial because there are so few controlled clinical trials. Further research is needed to elucidate the role of
micronutrient deficiencies on the course of
HIV infection, and the preventive and therapeutic role of supplementation in its clinical management. Nevertheless, current knowledge supports the use of routine multivitamin and
trace element supplementation as adjuvant to conventional antiretroviral
drug treatment as a relatively low-cost intervention.