Table 1.

Comparison of effects of HIV infection and malnutrition on various parameters of the immune system [20, 24, 47, 52–55].

Immunological parameter	Effect of HIV infection	Effect of malnutrition	Nutrient deficiency
Total lymphocytes	Decreased	Decreased	PEM
T lymphocytes	Decreased	Decreased	PEM
CD4 T lymphocytes	Decreased	Decreased	PEM
CD8 T lymphocytes	Transient increase, then decrease	Relatively maintained	—
CD4: CD8 T-cell ratio	Inverted	Reversed	PEM
Lymphocyte responsiveness to mitogens/antigens	Reduced	Reduced	PEM, vitamin A, E, zinc, iron
Cell-mediated immunity	Compromised	Compromised	PEM, essential amino acids (pyridoxine)
B lymphocytes	Polyclonal activation	Generally maintained	—
Immunoglobulin levels	Increased (IgA, IgG)	Reduced (IgA, IgG, IgM)	PEM, amino acids, vitamin B complex
Secretory IgA (sIgA)	Increased	Decreased	PEM
B-cell activity	Reduced	Reduced	PEM,
Primary antibody responses	Reduced	Reduced	PEM
Antibody affinity	Decreases with increase in HIV progression	Reduced	PEM
NK cell activity	Increased	Reduced	Vitamin A, C, zinc, iron, selenium
Serum complement	Increased	Reduced	PEM, essential amino acids
Serum β-2 microglobulin	Increased, marker of HIV progression	Increased	PEM
IFN-γ	Increased	Reduced	Amino acids, essential fatty acids, iron
TNF-α, IL-6	Increased	Increased	PEM
Anti-inflammatory Cytokines (IL-4)	Reduced	Increased	PEM
Soluble IL-2 receptors	Increased	Reduced	PEM
Antioxidants	Reduced	Reduced	Essential amino acids (arginine), selenium, zinc, manganese, copper, vitamins A, C, E
C-reactive protein	Increased, marker of HIV disease progression	Increased	PEM