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Evidence for beneficial effect of combinatorial micronutrition in early stage of HIV disease

HIV infection and immunity

Since the epidemic began, 30 years ago, more than 60 million people have been infected with HIV and nearly 30 million people have died of causes associated with the infection. It is estimated that 35.3 million people worldwide are living with HIV today, with Sub-Saharan Africa remaining the region most affected by the epidemic.

The main target of HIV is the immune system itself, that is to say the body’s natural defense against the disease, which is then gradually shut down. During infection, the virus invades and neutralizes a class of white blood cells (cells that help the body fight infection and disease) called CD4 T lymphocytes.

The question on when to initiate an antiretroviral therapy (ART) usually depends on the CD4 cell count. Nevertheless, already in early stages of the disease, even before the outbreak of symptoms, micronutrient deficiencies are present and associated with accelerated HIV disease progression (1).

HIV-infection and nutrition

Clinical trials have already shown that micronutrient supplementation was able to improve markers of HIV disease progression, such as CD4 cell count or HIV viral load. Results of a meta-analysis revealed that HIV-infected adults could definitely benefit from multiple micronutrient supplementations, which could decrease the mortality and morbidity (2).

The micronutrients of interest here are those known to influence immune functions, mainly B vitamins, vitamins C and E and trace element Selenium, the latter being thought to play a role in preventing HIV replication (1, 3).

Nevertheless all clinical trials were conducted in late stages of the HIV disease (4-6) or in pregnant women (7).

Beneficial effect of combined supplementation with vitamins and selenium of HIV-infected adults in Botswana

Recently, a new clinical study published in JAMA showed that 24-month supplementation with a single supplement containing multivitamins and selenium delayed HIV disease progression by significantly improving immunity in HIV-infected adults in the early stages of the disease and who were thus not yet eligible to ART (8). Enrolling 878 participants, the study was conducted in Botswana, a sub-Saharan African country that reports the highest rates of HIV infection in the world.

Interestingly, the study showed that only the combination of multivitamins and selenium had a beneficial outcome, whereas multivitamins alone or selenium alone were not statistically different from placebo.

The idea here is very similar to the way of action of Actigenomics’ product Immunitum®, which is also based on a soon to be patented combination of specific natural ingredients and was shown to improve immunity in HIV patients. Two clinical studies were conducted with Immunitum® in Togo. They also included a group of HIV-infected patients who were not yet eligible for ART treatment.

These studies support the use of combinatorial micronutrition as an effective intervention to reduce the risk of disease progression in HIV-affected adults, in early stages of the disease.

1.    Baum MK, Shor-Posner G, Lu Y, Rosner B, Sauberlich HE, Fletcher MA, Szapocznik J, Eisdorfer C, Buring JE and Hennekens CH (1995) Micronutrients and HIV-1 disease progression. AIDS  9: 1051-6
2.    Jiang S, He J, Zhao X and Li H (2012) The effect of multiple micronutrient supplementation on mortality and morbidity of HIV-infected adults: a meta-analysis of randomized controlled trials. J Nutr Sci Vitaminol (Tokyo)  58: 105-12
3.    Hurwitz BE, Klaus JR, Llabre MM, Gonzalez A, Lawrence PJ, Maher KJ, Greeson JM, Baum MK, Shor-Posner G, Skyler JS and Schneiderman N (2007) Suppression of human immunodeficiency virus type 1 viral load with selenium supplementation: a randomized controlled trial. Arch Intern Med  167: 148-54
4.    Jiamton S, Pepin J, Suttent R, Filteau S, Mahakkanukrauh B, Hanshaoworakul W, Chaisilwattana P, Suthipinittharm P, Shetty P and Jaffar S (2003) A randomized trial of the impact of multiple micronutrient supplementation on mortality among HIV-infected individuals living in Bangkok. AIDS  17: 2461-9
5.    Kaiser JD, Campa AM, Ondercin JP, Leoung GS, Pless RF and Baum MK (2006) Micronutrient supplementation increases CD4 count in HIV-infected individuals on highly active antiretroviral therapy: a prospective, double-blinded, placebo-controlled trial. J Acquir Immune Defic Syndr  42: 523-8
6.    Range N, Changalucha J, Krarup H, Magnussen P, Andersen AB and Friis H (2006) The effect of multi-vitamin/mineral supplementation on mortality during treatment of pulmonary tuberculosis: a randomised two-by-two factorial trial in Mwanza, Tanzania. Br J Nutr  95: 762-70
7.    Fawzi WW, Msamanga GI, Spiegelman D, Wei R, Kapiga S, Villamor E, Mwakagile D, Mugusi F, Hertzmark E, Essex M and Hunter DJ (2004) A randomized trial of multivitamin supplements and HIV disease progression and mortality. N Engl J Med  351: 23-32
8.    Baum MK, Campa A, Lai S, Sales Martinez S, Tsalaile L, Burns P, Farahani M, Li Y, van Widenfelt E, Page JB, Bussmann H, Fawzi WW, Moyo S, Makhema J, Thior I, Essex M and Marlink R (2013) Effect of micronutrient supplementation on disease progression in asymptomatic, antiretroviral-naive, HIV-infected adults in Botswana: a randomized clinical trial. JAMA  310: 2154-63


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