Micronutrient status indicators in individuals single- or double-infected with HIV and Wuchereria bancrofti before and after DEC treatment

OBJECTIVE: To identify possible associations between selected micronutrient status indicators (serum ferritin, retinol, beta-carotene, alpha-tocopherol, and the acute phase reactant alpha-1 antichymotrypsin) and infection with human immunodeficiency virus (HIV) or Wuchereria bancrofti, and to assess the effect of the antifilarial drug diethylcarbamazine (DEC) on the micronutrient status indicators in individuals positive for one or both of the two infections.

METHODS: Serum concentrations of ferritin, retinol, beta-carotene, alpha-tocopherol and the acute phase reactant alpha-1 antichymotrypsin were examined in 59 individuals with HIV, W. bancrofti infection, or both, in Tanga Region, Tanzania, before and 12 weeks after treatment with DEC.

RESULTS: HIV infection, but not W. bancrofti infection, was associated with higher serum ferritin concentrations and lower beta-carotene and alpha-tocopherol. Neither HIV infection nor W. bancrofti infection was associated with serum retinol. The four micronutrient status indicators and alpha-1 antichymotrypsin were generally lower at 12 weeks after treatment both in the DEC and the placebo groups.

CONCLUSIONS: The negative association between HIV infection and the antioxidant vitamins beta-carotene and alpha-tocopherol may be due to infection-induced oxidative stress, whereas W. bancrofti infection seemed not to be associated with oxidative stress. The drop in antioxidant vitamin concentrations after treatment may be due to oxidative stress induced by HIV progression (HIV infected) and inflammation around dead adult worms and microfilariae (W. bancrofti infected) rather than to an effect of DEC.