title: Vitamin A supplementation and genital shedding of herpes simplex virus among HIV-1-infected women: a randomized clinical trial.
abstract: Cross-sectional analyses have associated vitamin A deficiency with genital shedding of herpes simplex virus (HSV) among human immunodeficiency virus type 1 (HIV-1)-infected women. A randomized clinical trial of vitamin A supplementation given daily for 6 weeks was conducted among 376 women in Mombasa, Kenya, who were coinfected with HSV-2 and HIV-1. At follow-up, there was no significant difference in the detection of genital HSV DNA between women receiving vitamin A supplementation and women receiving placebo (40% vs. 44%, respectively; P = .5) Among women shedding HSV, there was no significant difference in the mean HSV DNA quantity between the group that received vitamin A supplementation and the group that received placebo (4.51 vs. 4.67 log10 copies/swab; P = .6). HSV shedding was associated with significantly higher vaginal and cervical HIV-1 shedding, even after controlling for the plasma HIV-1 load and the CD4 count. Vitamin A supplementation is unlikely to decrease HSV shedding and infectivity.
authors.affiliation: Department of Epidemiology, University of Washington, Seattle, Washington 98104-2499, USA. jbaeten@u.washington.du
authors.forename: Jared M
authors.initials: JM
authors.lastname: Baeten
authors.forename: R Scott
authors.initials: RS
authors.lastname: McClelland
authors.forename: Lawrence
authors.initials: L
authors.lastname: Corey
authors.forename: Julie
authors.initials: J
authors.lastname: Overbaugh
authors.forename: Ludo
authors.initials: L
authors.lastname: Lavreys
authors.forename: Barbra A
authors.initials: BA
authors.lastname: Richardson
authors.forename: Anna
authors.initials: A
authors.lastname: Wald
authors.forename: Kishorchandra
authors.initials: K
authors.lastname: Mandaliya
authors.forename: Job J
authors.initials: JJ
authors.lastname: Bwayo
authors.forename: Joan K
authors.initials: JK
authors.lastname: Kreiss
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D004279:DNA, Viral / Q000737:chemistry / Q000235:genetics; D004311:Double-Blind Method; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000821:virology*; D015497:HIV-1 / Q000502:physiology*; D006558:Herpes Genitalis / Q000276:immunology / Q000821:virology*; D018258:Herpesvirus 2, Human / Q000502:physiology*; D006801:Humans; D016133:Polymerase Chain Reaction; D017201:Virus Shedding / Q000187:drug effects; D014801:Vitamin A / Q000008:administration & dosage*
chemical_list: D004279:DNA, Viral; D014801:Vitamin A