IMPACT OF MICRONUTRIENTS ON PROGRESSION OF SIV

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DESCRIPTION : (duplicated from the abstract provided) Studies in patients with HIV infection have revealed that serum micronutrient levels are often below normal levels particularly for vitamins A, B12, E and for selenium. Some studies have correlated low micronutrient levels with more rapid progression of HIV infection. Intervention trials with micronutrients are extremely difficult to carry out in persons with HIV for the following reasons : a large percentage of HIV/AIDS patients are already taking nutritional supplements in an uncontrolled manner, some in large doses; intake of micronutrients in food varies greatly among persons with HIV infection; there are complex ethical issues surrounding a placebo controlled trial of micronutrients in the HIV/AIDS population; it would be difficult to maintain a micronutrient intervention study during the years of progression of HIV infection; and current and rapidly changing anti-retroviral therapies will alter the natural history of HIV, making it complex to separate out the effects of micronutrient intervention. Yet, micronutrient supplements might play an important role in improving overall nutritional status and slowing the progression of HIV infection. The Simian immunodeficiency virus (SIV) produces an infection in juvenile rhesus monkeys that is remarkably similar to that caused by HIV in humans including, as we have found recently, serum micronutrient deficiencies despite an apparently adequate intake. SIV also causes a wasting condition similar to that seen in young persons with HIV. Because of the rapid progression in SIV, and the clear end points of nutritional parameters, biological markers, and survival, as well as a controlled dietary intake, the SIV-infected rhesus monkey is an ideal model to examine the potential benefit of micronutrient supplementation. To this end we plan to: 1) document the course of micronutrient deficiency and weight loss in SIV-infected juvenile rhesus macaques compared to age matched uninfected control animals; and 2) conduct 3 interventions with micronutrients in SIV infected macaques, including a high supplementation with vitamins and trace minerals; single supplementation with vitamin B12 intramuscularly; and a single supplementation selenium. End points include time of death; body weight and lean body mass; serum micronutrients; viral load; CD4 cell count; and development of opportunistic infections. These studies will allow the evaluation of the efficacy of micronutrient supplements in the monkey SIV model without the confounding factors involved in a study in human HIV infection. In addition, the natural history of nutritional deficits and wasting would be defined in this model, which would provide a basis for further studies on nutritional interventions.