linoleic-acid and HIV-Infections

To determine whether certain nutrients and dietary factors act as modulators of the immune system and improve the nutritional status of immunocompromised patients.. Controlled, double-blind, crossover phase trials of the effects of a fortified formula in patients infected with the human immunodeficiency virus (HIV). Patients consumed a control formula for 4 months and a study formula for 4 months.. Ten men with symptomatic HIV infection who were following stable medication regimens and had no malignancies, mycobacteriosis, or additional virus infection requiring systemic treatment.. Formula fortified with alpha-linolenic acid (1.8 g/day), arginine (7.8 g/day), and RNA (0.75 g/day) and a standard formula.. Nutritional status determined by anthropometric, bioelectrical, biochemical, and dietary assessment; energy expenditure determined by indirect calorimetry; disease progression; CD4 lymphocyte counts; HIV p24 antigen plasma concentrations; tumor necrosis factor (TNF) receptor proteins; and compliance control parameters.. Student's t tests for paired and unpaired data.. Fortified nutrition resulted in a weight gain (+ 2.9 kg/4 months vs -0.5 kg/4 months with the control formula, P < .05), an incorporation of eicosaenoic acid into erythrocyte cell membranes (+ 47% of baseline values, P < .05), and increased plasma arginine concentrations (96.8 +/- 45.1 vs 51.8 +/- 20.9 mumol/L, P < .01). The serum concentrations of the soluble tumor necrosis factor receptor (sTNFR) proteins increased during the study period (sTNFR 55 = + 0.23 vs -0.40 ng/mL, P < .001; sTNFR 75 = + 0.90 vs -0.36 ng/mL, P < .01), whereas no changes in CD4+ lymphocyte counts were observed.. Increasing dietary intakes of n-3 polyunsaturated fatty acids, L-arginine, and RNA increased body weight, possibly by modulating the negative effects of TNF.

Topics: Adolescent; Adult; Aged; Anthropometry; Arginine; CD4-Positive T-Lymphocytes; Cross-Over Studies; Double-Blind Method; Energy Metabolism; Food, Formulated; Food, Fortified; HIV Antigens; HIV Infections; Humans; Immune System; Linoleic Acid; Linoleic Acids; Male; Middle Aged; Nutritional Status; Receptors, Tumor Necrosis Factor; RNA; Weight Gain

Dietary fat intake in the South African population is increasing. This population also has a high prevalence of HIV infection. However, information about metabolic effects of dietary fatty acids on HIV-infected subjects is lacking.. Our objective was to investigate the relation between dietary fatty acid intake and liver function in HIV-infected compared with HIV-uninfected subjects.. This cross-sectional epidemiologic survey included a representative sample of 1854 apparently healthy black volunteers aged > or =15 y, who were recruited from 37 randomly selected sites throughout the North West province of South Africa. Data from 216 asymptomatic HIV-infected and 1604 HIV-uninfected subjects were used.. Intakes of polyunsaturated fatty acids (PUFAs), linoleic acid (n-6), and the ratio of PUFAs to saturated fatty acids (SFAs) were positively associated with all the liver enzymes measured in HIV-infected subjects (R = 0.16-0.65). Most of these R values differed significantly from the R values for HIV-uninfected subjects. No associations were seen between liver enzymes and intakes of SFAs and monounsaturated fatty acids. Vitamin E intake was positively associated with serum gamma-glutamyl transpeptidase (R = 0.23), alanine aminotransferase (R = 0.37), and aspartate aminotransferase (R = 0.58) in HIV-infected subjects; these correlations differed significantly from those of the HIV-uninfected subjects because PUFA sources are the main carriers of vitamin E.. The results suggest that n-6 PUFA intakes may be related to liver damage in these HIV-infected asymptomatic subjects. The reasons or mechanisms responsible are not clear, and further research is necessary to determine the optimal safe amounts for intake of n-6 PUFAs by HIV-infected subjects, especially in countries with traditionally high intakes of n-6 PUFA-rich vegetable oils.

Topics: Adult; Alanine Transaminase; Aspartate Aminotransferases; Black People; Cross-Sectional Studies; Dietary Fats; Fatty Acids; Fatty Acids, Omega-6; Fatty Acids, Unsaturated; gamma-Glutamyltransferase; HIV Infections; Humans; Linoleic Acid; Liver; Liver Diseases; South Africa; Vitamin E

Review of the evidence available in published literature supports a radical change in viewpoint with respect to disease in countries where maize is the predominant dietary component. In these countries, the pattern of disease is largely determined by a change in immune profile caused by metabolites of dietary linoleic acid. High intake of linoleic acid in a diet deficient in other polyunsaturated fatty acids and in riboflavin results in high tissue production of prostaglandin E2, which in turn causes inhibition of the proliferation and cytokine production of Th1 cells, mediators of cellular immunity. Tuberculosis, measles, hepatoma, secondary infection in HIV and kwashiorkor are all favoured by this reduction in cellular immunity. Diet-associated inhibition of the Th1 subset is a major contributor to the high prevalence of these diseases found in areas of sub-Saharan Africa where maize is the staple.

Topics: Africa; Dinoprostone; HIV Infections; Humans; Immunity, Cellular; Kwashiorkor; Linoleic Acid; Liver Neoplasms; Measles; Th1 Cells; Tuberculosis; Zea mays

Fatty acids in plasma phospholipids were studied in 35 severely malnourished young children with a median age of 29 mo (range: 9-43 mo), who were either seronegative for human immunodeficiency virus-1 (HIV) (n = 16) or suffered from asymptomatic (stage P-1; n = 12) or symptomatic (stage P-2; n = 7) HIV disease. The malnourished children had significantly lower percentages (% by wt) of phospholipid arachidonic (20:4n-6, AA) and docosahexaenoic (22:6n-3, DHA) acids than 25 age-matched healthy control subjects (AA: 7.05% and 8.70% by wt; DHA: 0.92 and 2.61% by wt, P < 0.001). Body weights of malnourished children did not correlate with linoleic (18:2n-6) and alpha-linolenic (18:3n-3) acid values but were significantly and positively correlated with AA and DHA values (r = 0.40, P = 0.02 and r = 0.63, P < 0.0001, respectively). Plasma concentrations (mg/L) of total phospholipid fatty acids did not differ among seronegative, stage P-1, or stage P-2 patients. Percentage contributions of AA and eicosapentaenoic acid (20:5n-3, EPA) did not differ among those seronegative or in stages P-1 and P-2. In contrast, values of dihomo-gamma-linolenic acid (20:3n-6) were significantly (P < 0.05) lower in stage P-2 (2.38 mg/L) than in either seronegative (3.47 mg/L) or stage P-1 (3.66 mg/L) patients. We conclude that the severely malnourished children developed a depletion of both AA and DHA proportional to the degree of malnutrition.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Arachidonic Acids; Body Weight; Child, Preschool; Docosahexaenoic Acids; Eicosapentaenoic Acid; Fatty Acids, Unsaturated; HIV Infections; HIV-1; Humans; Infant; Linoleic Acid; Linoleic Acids; Phospholipids; Protein-Energy Malnutrition