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- Title
Vitamin C Urinary Loss and Deficiency in Human Immunodeficiency Virus (HIV): Cross-sectional Study of Vitamin C Renal Leak in Women With HIV.
- Authors
Ebenuwa, Ifechukwude; Violet, Pierre-Christian; Michel, Kate; Padayatty, Sebastian J; Wang, Yaohui; Tu, Hongbin; Wilkins, Kenneth J; Kassaye, Seble; Levine, Mark
- Abstract
Background Reduced plasma vitamin C (vitC) concentrations in human immunodeficiency virus (HIV) may result from abnormal urinary excretion: a renal leak. VitC renal leak indicates underlying nutritional dysregulation independent of diet. We hypothesized that increased renal leak prevalence in HIV would be associated with deficient vitC concentrations. Methods We conducted an outpatient cross-sectional study of 96 women (40 HIV [PWH] and 56 without HIV [PWOH]) at the National Institutes of Health and Georgetown University. Renal leak was defined as abnormal urinary vitC excretion at fasting plasma concentrations <43.2µM, 2 SDs below vitC renal threshold in healthy women. To determine the primary outcome of renal leak prevalence, matched urine and plasma samples were collected the morning after overnight fast. Secondary outcomes assessed group differences in mean plasma vitC concentrations and prevalence of vitC deficiency. Exploratory outcomes assessed clinical parameters associated with renal leak. VitC was measured by high-performance liquid chromatography with coulometric electrochemical detection. Results PWH had significantly higher renal leak prevalence (73%vs14%; OR (odds ratio):16; P <.001), lower mean plasma vitC concentrations (14µMvs50µM; P <.001), and higher prevalence of vitC deficiency (43%vs7%; OR:10; P <.001) compared with PWOH, unchanged by adjustments for confounding factors. Significant predictors of renal leak included antiretroviral therapy (ART), Black race, older age, and metabolic comorbidities but not viral load or CD4 count. When compared with other chronic disease cohorts, PWH had the highest prevalence of renal leak and vitC deficiency (P <.001). Conclusions High prevalence of vitC renal leak in HIV was associated with vitC deficiency, ART use, and race/ethnicity differences.
- Subjects
WASHINGTON (D.C.); HIV infections; HIV-positive persons; CONFOUNDING variables; NATIONAL Institutes of Health (U.S.); HIGH performance liquid chromatography; CONFIDENCE intervals; CROSS-sectional method; VITAMIN C deficiency; VITAMIN C; ANTIRETROVIRAL agents; RACE; KIDNEY diseases; TREATMENT effectiveness; COMPARATIVE studies; DESCRIPTIVE statistics; RESEARCH funding; ODDS ratio; COMORBIDITY
- Publication
Clinical Infectious Diseases, 2023, Vol 77, Issue 8, p1157
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciad333