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Standard-Dose vs High-Dose Multivitamin Supplements for HIV

Sebastian J. Padayatty, MD, PhD; Mark Levine, MD
JAMA. 2013;309(6):545-546. doi:10.1001/jama.2012.216991.
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To the Editor: In the study by Dr Isanaka and colleagues,1 patients with human immunodeficiency virus (HIV) receiving highly active antiretroviral therapy were treated either with standard-dose or high-dose multivitamin supplements, with no difference in outcomes. The authors concluded that high-dose vitamin supplements have no benefit in these patients.

Higher doses of vitamins should result in higher plasma or tissue vitamin concentrations. For vitamin C, the dose-concentration relationship in healthy young women is sigmoidal.2 Rapid increases in plasma concentrations occur at intakes of 30 mg/d to 100 mg/d, with only small increases at higher intakes. For the doses of 80 mg/d (standard-dose regimen) and 500 mg/d (high-dose regimen) of vitamin C used in this study, predicted plasma vitamin C concentrations are 55 μM and 74 μM, respectively, using published dose-concentration curves.2

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February 13, 2013
Sheila Isanaka, ScD; Ferdinand Mugusi, MD; Wafaie W. Fawzi, MBBS, DrPH
JAMA. 2013;309(6):545-546. doi:10.1001/jama.2012.216995.
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