Original Contributions

Metabolic Brain Disease

, Volume 6, Issue 4, pp 207-212

First online:

Thiamine deficiency and wernicke's encephalopathy in AIDS

  • Roger F. ButterworthAffiliated withLaboratory of Neurochemistry, André-Viallet Clinical Research Center, Hôpital Saint-Luc (University of Montreal)
  • , Christiane GaudreauAffiliated withMicrobiology Service, Hôpital Saint-Luc (University of Montreal)
  • , Jean VinceletteAffiliated withMicrobiology Service, Hôpital Saint-Luc (University of Montreal)
  • , Anne-Marie BourgaultAffiliated withMicrobiology Service, Hôpital Saint-Luc (University of Montreal)
  • , Francois LamotheAffiliated withMicrobiology Service, Hôpital Saint-Luc (University of Montreal)
  • , Anne-Marie NutiniAffiliated withHematology Service, Hôpital Saint-Luc (University of Montreal)

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Several neuropathological reports in the last 5 years have described brain lesions characteristic of Wernicke's Encephalopathy in patients with AIDS. Using the erythrocyte transketolase activation assay, we now report biochemical evidence of thiamine deficiency in 9/39 (23%) of patients with AIDS or AIDS-related complex. In no cases was there history of alcohol abuse nor were there clinical signs of Wernicke's Encephalopathy. Thiamine deficiency in these patients most likely results from the cachexia and catabolic state characteristic of AIDS. In view of (i) the confirmed neuropathological evidence of Wernicke's Encephalopathy in AIDS patients, (ii) the significant thiamine deficiency in these patients and (iii) the difficulties of clinical diagnosis of Wernicke's Encephalopathy, it is recommended that dietary thiamine supplementation be initiated in all newly diagnosed cases of AIDS or AIDS-related complex.

Key words

AIDS AIDS-related complex thiamine deficiency Wernicke's Encephalopathy α-ketoglutarate dehydrogenase transketolase