Effect of providing vitamin supplements to human immunodeficiency virus-infected, lactating mothers on the child's morbidity and CD4+ cell counts.
A total of 1078 human immunodeficiency virus (HIV) type 1-infected women from Tanzania were randomized in a placebo-controlled trial using a factorial design to examine the effects of supplementation with vitamin A (preformed vitamin A and beta carotene) and/or multivitamins (vitamins B, C, and E). Supplements were given during pregnancy and lactation. Children of women in the multivitamin arms had a significantly lower risk of diarrhea than did those in the no-multivitamin arm (P=.03). The mean CD4+ cell count was 151 cells/microL higher among children in the multivitamin arms than among those in the no-multivitamin arm (P=.0006). HIV-positive children experienced a benefit apparently similar to that in HIV-negative children (P=.34, by test for interaction). Maternal receipt of vitamin A significantly reduced the risk that the child would have cough with a rapid respiratory rate, a proxy for pneumonia (P=.03), but receipt of vitamin A had no effect on diarrhea or CD4+ cell count. Provision of multivitamin supplements (including those with vitamins B, C, and E) to HIV-infected, lactating women may be a low-cost intervention to improve their children's health.
Fawzi
Wafaie W
WW
Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts 02115, USA. mina@hsph.harvard.edu
Msamanga
Gernard I
GI
Wei
Ruilan
R
Spiegelman
Donna
D
Antelman
Gretchen
G
Villamor
Eduardo
E
Manji
Karim
K
Hunter
David
D
D000328:Adult; D018791:CD4 Lymphocyte Count; D003967:Diarrhea / Q000453:epidemiology / Q000517:prevention & control; D019587:Dietary Supplements; D005260:Female; D015658:HIV Infections / Q000276:immunology*; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007774:Lactation; D009017:Morbidity; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology*; D011297:Prenatal Exposure Delayed Effects; D014815:Vitamins / Q000191:economics / Q000494:pharmacology* / Q000627:therapeutic use
D014815:Vitamins