Prevalence of Vitamin B₁₂ and folic acid deficiency in HIV-positive patients and its association with neuropsychiatric symptoms and immunological response

Background: Deficiency of micronutrients is prevalent even before the development of symptoms of HIV disease and is associated with accelerated HIV disease progression. Aims: This study evaluates the prevalence of folate and Vitamin B₁₂deficiency in HIV-positive patients with or without tuberculosis (TB) and its association with neuropsychiatric symptoms and immunological response. Settings and Design: Cross-sectional, observational study in an outpatient setting. Patients and Methods: Four groups of HIV-positive patients with TB (Group I), HIV-positive patients with neuropsychiatric symptoms (Group II), HIV-positive patients without neuropsychiatric symptoms or TB (Group III), and HIV-negative controls with neuropsychiatric symptoms (Group IV). Vitamin B₁₂and folate estimation was done using carbonyl metallo-immunoassay method. Statistical Analysis Used: ANOVA, Kruskal-Wallis and Mann-Whitney, Pearson's correlation. Results: The prevalence of folic acid deficiency was 27.1% in the Group I, 31.9% in the Group II, 23.4% in the Group III, and 32% in the Group IV being higher in patients with neuropsychiatric symptoms in both HIV and non-HIV patients. The prevalence of Vitamin B₁₂deficiency was 18.8% in Group I, 9.1% in Group II, 4.8% in Group III, and 16.7% in Group IV. The patients with folate deficiency had more severe depression and anxiety. Conclusion: Nearly, 30% of the HIV patients had a folic acid deficiency, and about 10% of the HIV patients had Vitamin B₁₂deficiency. The folate deficiency was highest among neuropsychiatric patients with or without HIV infection and Vitamin B₁₂deficiency was higher among HIV patients with TB.