Serum vitamin A concentrations in a North American cohort of human immunodeficiency virus type 1-infected children. National Institute of Child Health and Human Development Intravenous Immunoglobulin Clinical Trial Study Group.
BACKGROUND
Vitamin A deficiency is associated with increased risks of vertical transmission of HIV-1 (HIV) and of disease progression and mortality among HIV-infected adults. The objectives of the study were to describe serum vitamin A concentrations among HIV-infected children in the National Institute of Child Health and Human Development IVIG Clinical Trial, to examine changes in vitamin A concentrations and to investigate the relationships between vitamin A concentrations and morbidity and mortality.


METHODS
Blood was collected from children at baseline and at 3-month intervals throughout the study. Serum samples were stored at -70 degrees C at a central repository until retrieved for vitamin A assay. Samples were hexane-extracted and assayed by high performance liquid chromatography. The rate of change in vitamin A concentrations, calculated by fitting a linear regression model, was expressed as micrograms/dl/year.


RESULTS
The median vitamin A concentration at baseline (n = 207 children) was 31.0 microg/dl [range, undetectable (< 10 microg/dl) to 98 microg/dl]. The rate of change in vitamin A concentrations (n = 180 children) did not vary significantly by any factor other than baseline vitamin A concentration. Baseline vitamin A concentration was not associated with morbidity (incidence of infections, growth failure, CD4+ percent decline below 15%, increases in serum HIV RNA concentrations above either 10(5) or 10(6) copies/ml or acute care hospitalization). Neither baseline vitamin A concentration nor the rate of change of vitamin A concentrations was associated with mortality.


CONCLUSIONS
Among these North American children with relatively normal vitamin A concentrations, vitamin A was not observed to be associated with morbidity or mortality.
Pediatric, Adolescent and Maternal AIDS Branch, National Institute of Child Health and Human Development, Bethesda, MD 20892-7510, USA. jr92o@nih.gov
J S
JS
Read
J
J
Bethel
D R
DR
Harris
W A
WA
Meyer
J
J
Korelitz
L M
LM
Mofenson
J
J
Moye
S
S
Pahwa
K
K
Rich
R P
RP
Nugent
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000401:mortality; D015497:HIV-1; D006801:Humans; D007223:Infant; D008297:Male; D009017:Morbidity; D009656:North America / Q000453:epidemiology; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D016019:Survival Analysis; D014801:Vitamin A / Q000097:blood*
D012367:RNA, Viral; D014801:Vitamin A