Serum pyridoxine levels in HIV-positive patients and its association with tuberculosis and neuropsychiatric manifestations

Background: Studies have shown the prevalence of micronutrient insufficiency in HIV patients. Decreased plasma levels of pyridoxine, Vitamins B12, A, and E, and zinc have been correlated with significant alterations in immune response and cognitive functions. Serum pyridoxine levels in different subgroup of HIV patients are not well studied. Objective: To study the proportion of pyridoxine deficiency in different subgroups of HIV-positive patients (HIV with tuberculosis - Group I, HIV with neuropsychiatric manifestations - Group II, and HIV-positive patients without neuropsychiatric symptoms or tuberculosis - Group III) and the comparison of mini mental state examination (MMSE) score, Hamilton depression rating scale (HAM-D), and Hamilton anxiety rating scale (HAM-A) in them. Methodology: One hundred and fifty HIV patients were divided into three groups. MMSE, HAM-D, HAM-A, hemoglobin levels, pyridoxine levels, waist-hip ratio, and body mass index were noted. Results: The proportion of patients with pyridoxine deficiency was 18.8% in Group I and 28.3% in Group II. The percentage of pyridoxine deficiency between Group II and Group III significantly differ (P = 0.048). Patients in Group II showed an association with abnormal neuropsychiatric assessment using MMSE/HAM-D/HAM-A (χ² = 7.843; P = 0.005). There was a significant correlation between CD4 count and pyridoxine in Group I (r = 0.391, P = 0.006) only. Interpretation and Conclusions: Increased proportion of pyridoxine deficiency is seen in individuals with HIV. Proportion of pyridoxine deficiency is also higher in HIV patients with neuropsychiatric manifestations. HIV patients with neuropsychiatric symptoms and tuberculosis have a low CD4 count and pyridoxine levels as compared to HIV-positive patients without neuropsychiatric symptoms or tuberculosis.