Association of serum vitamin B(12) with immuno-hematological parameters in treatment-naive HIV positive cases

BACKGROUND: The manifestations of human immunodeficiency virus (HIV) infection and vitamin B(12) deficiency overlap each other, so early diagnosis and intervention is important. The study aims to find out serum vitamin B(12) level and its association with CD4 and CD8 count, clinical-staging, and hemato-biochemical status in newly diagnosed HIV positive cases. METHODOLOGY: Fifty-five confirmed HIV cases above 18 years of age and equal number of age and sex matched controls were recruited for the study. CD4 and CD8 counts were analyzed by Flow cytometer. Complete Blood Count, Serum vitamin B(12), Folic acid, ferritin, and C-Reactive Protein (CRP) concentration were done. RESULTS: Serum vitamin B(12) was observed to be significantly low in HIV positive cases than healthy controls with a mean value of 240.62 ± 56.75 pg/ml and 317.57 ± 52.56 pg/ml, respectively. Decreased CD4 counts with elevated levels of ferritin and CRP was seen in HIV positive individuals. The subgroup analysis based on the levels of vitamin B(12) was directly proportional to CD4 counts. CD8 counts also registered a significant association with serum B(12) level, yet the response is not proportionate with the level of vitamin B(12) deficiency. Nearly one-third of HIV positive cases revealed vitamin B(12) deficiency. CONCLUSION: During the early stage, fast dividing immune cells cause increased consumption of micronutrients contributing toward vitamin B(12) deficiency. It contributes to disorders in methylation affecting the immune function and NK Cell activity which increases the number of CD8 cells. Hence, vitamin B(12) is a beneficial immunological modulator of HIV infection and can be a potent game changer in resource constrained set up.