Prevalence of Vitamin B12 Deficiency in Antiretroviral Therapy Naïve Adults with Human Immunodeficiency Virus Infection in a Human Immunodeficiency Virus Treatment Center in Lagos, Nigeria

Abstract

Background: Vitamin B12 deficiency is reportedly higher in human immunodeficiency virus(HIV) infection, according to reports from developed countries and is associated with worsening anemia, progressing immunodeficiency (reduced CD4 count), and reduced survival rates. The status in Nigerians with HIV has not been extensively studied. The objective of the study was to determine the frequency and correlates of Vitamin B12 deficiency in HIV‑positive antiretroviral therapy (ART) naive patients attending an outpatient HIV clinic in Lagos, Nigeria. Specifically, the study compared HIV-positive ART-naïve patients to age- and gender-matched HIV-negative controls and determined the relationship between B12 status and HIV disease severity (CD4 count) and hemoglobin (Hb). Methodology: The study was a descriptive study of the prevalence of Vitamin B12 deficiency and its correlation with disease severity in HAART‑naïve newly diagnosed HIV infection. Seventy‑five ART naïve, HIV‑positive patients and 75 controls fulfilling the study criteria were included. Baseline hematologic (Hb, white blood cell, platelets, and CD4 count) and Vitamin B12 levels were measured. Vitamin B12 levels were measured using urine methylmalonic acid (MMA) on spot urine normalized for urine creatinine. B12 deficiency was defined as urine MMA >3.6 mmol/mol urinary creatinine. CD4 count (cells/µL) was categorized as <200, 200–499, and >500. Results: The frequency of B12 deficiency was 29.3% (22/75) in HIV‑positive cases and 0% (0/75) in controls (p < 0.001). There was no difference in the frequency of anemia in HIV cases with or without B12 deficiency (54.5% vs. 58.5%; p = 0.75). There was no significant difference in the proportions of HIV cases with or without B12 deficiency in the CD4 categories 1 (>500), 2 (200‑499) and 3 (<200), (1: 31.8% vs. 24.5%; 2: 40.9% vs. 50.9%; 3: 27.5% vs. 24.5%, respectively; p = 0.71). Neither severity of HIV infection nor Hb levels was found to be associated with B12 status (p > 0.05). Conclusion: Vitamin B12 deficiency was more prevalent in HIV‑positive ART naïve cases compared to age‑ and gender‑matched HIV‑negative controls. However, the presence of B12 deficiency was not associated with anemia or the severity of HIV infection in this study.