title: Effect of providing vitamin supplements to human immunodeficiency virus-infected, lactating mothers on the child's morbidity and CD4+ cell counts.
abstract: 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.
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts 02115, USA. mina@hsph.harvard.edu
authors.forename: Wafaie W
authors.initials: WW
authors.lastname: Fawzi
authors.forename: Gernard I
authors.initials: GI
authors.lastname: Msamanga
authors.forename: Ruilan
authors.initials: R
authors.lastname: Wei
authors.forename: Donna
authors.initials: D
authors.lastname: Spiegelman
authors.forename: Gretchen
authors.initials: G
authors.lastname: Antelman
authors.forename: Eduardo
authors.initials: E
authors.lastname: Villamor
authors.forename: Karim
authors.initials: K
authors.lastname: Manji
authors.forename: David
authors.initials: D
authors.lastname: Hunter
mesh_terms: 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
chemical_list: D014815:Vitamins