Vitamin B-12 abnormalities in HIV-infected patients.
European Journal of Haematology 1991 Jul;47(1):60-4 (ISSN: 0902-4441)
Remacha AF; Riera A; Cadafalch J; Gimferrer E Hematology Department,
Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
A prospective study of 60 consecutively admitted patients with HIV infection
was performed to document the prevalence, etiology and manifestations
of low serum vitamin B-12 in such patients. Low serum B-12 levels were
found in 10 patients (16.7%). In 6, vitamin B-12 absorption was impaired
and hog intrinsic factor addition did not improve it. Patients with low
vitamin B-12 levels showed lower hemoglobin, leukocytes, lymphocytes,
CD4 lymphocytes and CD4/CD8 lymphocyte ratio than HIV patients with physiological
serum vitamin B-12 levels. However, bone marrow megaloblastosis was found
in only 3 low vitamin B-12 patients and the deoxyuridine suppression test
was pathological in only 1 case. In 7 patients, parenteral treatment was
begun with variable response despite serum vitamin B-12 correction. In
conclusion, low serum vitamin B-12 is often found in HIV-infected patients
and it could be related to malabsorption, but clear megaloblastic abnormalities
and treatment response could not be demonstrated. A decreased concentration
of the serum binders due to disturbances in the leukocytes and related
immunocompetent cell may play an additional role.