A pellagra-like state can develop in malnourished patients with HIV and this may be due to impaired niacin status (Monteiro et al 2004) and result in tryptophan depletion. As tryptophan is preferentially converted to vitamin B3 (if B3 is depleted), a trial was conducted using high-dose niacin for 2 months in HIV patients and it was found that the high-dose niacin increased plasma tryptophan levels by 40% (Murray et al 2001).
An open, prospective trial has also concluded that extended-release niacin therapy is safe and effective for the treatment of dyslipidaemia associated with antiretroviral therapy; 2000 mg/day was given to 14 subjects for 14 weeks and resulted in significant reductions in serum levels of triglycerides, total cholesterol, and non-HDL-cholesterol (Gerber et al 2004).
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