Relationship Between Markers of HIV-1 Disease Progression and Serum Beta-Carotene Concentrations in Kenyan Women

Observational studies have suggested that low serum s-carotene concentrations may influence HIV-1 disease progression. However randomized trials have not demonstrated beneficial effects of s-carotene supplementation. To understand this discrepancy we conducted a cross-sectional study among 400 HIV-1-seropositive women in Mombasa Kenya to correlate serum s-carotene concentrations with several measures of HIV-1 disease severity. s-Carotene concentrations were significantly associated with biologic markers of HIV-1 disease progression (CD4 count HIV-1 plasma viral load serum C-reactive protein [CRP] concentration and serum albumin level). In multivariate analysis s-carotene concentrations below the median were associated with elevated CRP (>10 mg/l adjusted odds ratio [aOR] 3.32 95% confidence interval [CI] 1.99-5.53 P < 0.001) and higher HIV-1 plasma viral load (for each log10 copies/mL increase aOR 1.38 95% CI 1.01-1.88 P = 0.04). In the context of negative findings from randomized trials of s-carotene supplementation in HIV-1-seropositive individuals these results suggest that low s-carotene concentrations primarily reflect more active HIV-1 infection rather than a deficiency amenable to intervention. (authors)