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Supplemental vitamin B and progression to AIDS and death in black South African patients infected with HIV.

This letter to the editor provides information on supplemental vitamin B and progression to AIDS and death in Black South African patients infected with HIV. Recent studies have identified deficiencies in micronutrients that affect rate of AIDS progression and/or death in patients infected with HIV; however no clinical endpoint studies of vitamin supplementation have been published. For this study a large retrospective observational database containing detailed medical records on 2178 HIV-positive patients between 1985 and 1997 was developed. A case control study of 175 pairs of Black HIV-positive patients was performed. Classification tree analysis (CTA) was used to identify variables. Results showed that MULTIVITS (including all medications of the class of multivitamins) was the best predictor of AIDS progression for non-whites (0.53). The median survival period for patients without vitamins was 144.8 weeks; for those who took vitamin B 264.6 weeks (p = 0.0014). This demonstrates the vitamins effect on both humoral and cellular immunity. The average duration of vitamin B use was 26 weeks with doses ranging from 1 tablet/day to 50 mg/day of pyridoxine. The subgroup with no vitamin supplementation however may represent a higher risk group and this may have affected their collective longevity. Overall the analyses demonstrate a positive relationship between therapeutic vitamin B use and delay of AIDS progression and death in Black HIV-positive patients in South Africa. Further controlled trials are needed to clarify the role of vitamin B supplementation in HIV treatment.