Micronutrients: implications in human immunodeficiency virus disease

The use of vitamins and minerals has been the target of more interest than that of any other category of drugs. Deficiencies of vitamins and minerals have been documented during various phases of human immunodeficiency virus (HIV) infection, and animal and human studies suggest that some micronutrients play an important role in immunity. Evidence indicates that slightly excessive intakes of certain nutrients (ie, beta carotene, vitamins A and E, zinc, and selenium) may be associated with enhanced immune responsiveness. Proponents of megadoses take this information one step further and suggest that nutrients taken in large quantities will help restore the immune response and combat disease. Although animal studies suggesting immunostimulation should not be ignored, it is premature to make definitive statements concerning excess micronutrient intakes in humans. Are the recommended dietary allowances (RDAs) sufficient intake for the HIV infected population or would therapeutic doses be clinically indicated? This article reviews micronutrients in HIV disease and deficiencies specific to HIV. Toxicities associated with megadoses of nutrients are addressed and guidelines presented for the clinical practitioner. References cited have been limited to human studies.