Effect of prenatal vitamin supplementation on lower-genital levels of HIV type 1 and interleukin type 1 beta at 36 weeks of gestation.
Micronutrient status has been associated with shedding of human immunodeficiency virus type 1 (HIV-1) in the lower-genital tract in observational studies. We examined the effect of vitamin supplements on genital HIV-1 shedding and interleukin-1 beta (IL-1 beta ), a cytokine marker of vaginal inflammation and promotion of HIV-1 infection. Consenting HIV-1-infected pregnant women were randomized to receive daily supplementation with vitamin A and/or multivitamins B-complex, C, and E with use of a factorial design. Cervicovaginal lavage (CVL) specimens were obtained shortly before delivery. Significantly more women who received vitamin A had detectable levels of HIV-1 in CVL (74.8%), compared with those who did not receive vitamin A (65.1%) (P=.04, by multivariate analysis). Multivitamin B-complex, C, and E had no effect on the risk of viral shedding. Our results raise concern about the use of vitamin A supplements by HIV-1-infected women. Use of prenatal multivitamin supplements (including vitamins B-complex, C, and E) should be continued despite the lack of effect on HIV-1 transmission because of previously reported positive effects on maternal health and pregnancy outcomes.
Fawzi
Wafaie
W
Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts 02115, USA. mina@hsph.harvard.edu
Msamanga
Gernard
G
Antelman
Gretchen
G
Xu
Chong
C
Hertzmark
Ellen
E
Spiegelman
Donna
D
Hunter
David
D
Anderson
Deborah
D
D001205:Ascorbic Acid / Q000494:pharmacology; D019587:Dietary Supplements; D005260:Female; D015658:HIV Infections / Q000378:metabolism / Q000821:virology; D015497:HIV-1 / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D007375:Interleukin-1 / Q000378:metabolism*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D019562:Viral Load; D014803:Vitamin B Complex / Q000494:pharmacology; D014810:Vitamin E / Q000494:pharmacology; D014815:Vitamins / Q000494:pharmacology*
D007375:Interleukin-1; D014815:Vitamins; D014803:Vitamin B Complex; D014810:Vitamin E; D001205:Ascorbic Acid