Aids Research
Vitamin B12 malabsorption in patients with acquired immunodeficiency
syndrome.
Archives of internal medicine; VOL: 149 (9); p. 2039-41
Harriman GR; Smith PD; Horne MK; Fox CH; Koenig S; Lack EE; Lane HC;
Fauci AS
We have examined 11 patients with the acquired immunodeficiency syndrome
(AIDS) for evidence of subclinical vitamin B12 malabsorption. Three subjects
(27%) had low levels of vitamin B12. Eight subjects (73%), including
these 3 subjects plus 5 others with normal vitamin B12 levels, had abnormal
Schilling test results. In addition, 15% of an unselected population
of 121 patients with AIDS and 7% of 27 patients without AIDS who were
seropositive for human immunodeficiency virus type 1 (HIV-1) had low
serum vitamin B12 levels. Stool cultures from the 8 subjects with abnormal
Schilling test results revealed no pathogens. Intestinal involvement
by Kaposi's sarcoma was found in only 1 patient. Biopsy specimens from
5 of 6 patients with vitamin B12 malabsorption, however, contained mononuclear
cells harboring HIV-1, as indicated by in situ hybridization studies.
Our observations suggest that vitamin B12 malabsorption is common in
patients with AIDS and may be a very early manifestation of infection
with HIV-1.
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