To the Editor.
—I was delighted to see the excellent article by Beach et al,1 presenting evidence that concurrent vitamin B12 deficiency may be a cofactor in subtle cognitive changes in the human immunodeficiency virus type-1 infection.Their data confirmed our evidence of the same thing, presented at the October 1989 Robert Schilling Festschrift at the University of Wisconsin in Madison and published in June 1990.2 Our article was apparently missed by Beach et al in their literature search.As we delineated in our article,2 finding a low serum vitamin B12 level on transcobalamin II picked up inadequate vitamin B12 delivery to the nervous system, even before the total serum vitamin B12 level fell below the range of normal, and demonstrated such inadequacy in 53% of patients with acquired immunodeficiency syndrome, rather than the 25% found by Beach et al when they measured
Herbert V. Vitamin B12 Deficiency Neuropsychiatric Damage in Acquired Immunodeficiency Syndrome. Arch Neurol. 1993;50(6):569. doi:10.1001/archneur.1993.00540060011006
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