Micronutrient status during lactation in HIV-infected and HIV-uninfected South African women during the first 6 mo after delivery.
BACKGROUND
Little information on the micronutrient status of HIV-infected (HIV-positive) breastfeeding women is available.


OBJECTIVE
The objective was to compare the protein and micronutrient status of South African breastfeeding women by HIV status.


METHODS
Serum albumin, prealbumin, vitamin B-12, folate, retinol, alpha-tocopherol, hemoglobin, ferritin, and zinc concentrations were compared between 92 HIV-positive and 52 HIV-uninfected (HIV-negative) mothers 6, 14, and 24 wk after delivery. C-reactive protein and alpha1-acid glycoprotein were used as proxy indicators of an inflammatory process.


RESULTS
Mean albumin and prealbumin were significantly lower in HIV-positive mothers, and a higher proportion of HIV-positive mothers had low albumin concentrations (< 35 g/L). Less than 45% of the mothers were vitamin B-12 or folate sufficient. Significantly more HIV-positive (70.5%) than HIV-negative (46.2%) mothers had marginal vitamin B-12 status (P < 0.05), and mean folate concentrations were lower in HIV-positive mothers (P = 0.05). Mean serum retinol was significantly lower in HIV-positive mothers, even after control for the acute phase response. At 24 wk, 70% of both groups had an alpha-tocopherol deficiency (< 11.6 micromol/L), but no significant difference by HIV status was observed. More HIV-positive (33.3%) than HIV-negative (8.7%) mothers had anemia (P = 0.018), whereas 25% of all mothers had low serum ferritin concentrations. After the acute phase response was controlled for, zinc deficiency was more common in HIV-positive (45.0%) than in HIV-negative (25.0%) mothers (P = 0.05).


CONCLUSIONS
Deficiencies in vitamins B-12, folate, alpha-tocopherol, ferritin, and zinc are common in South African breastfeeding mothers. HIV-positive mothers had lower mean serum concentrations of albumin, prealbumin, folate, retinol, and hemoglobin than did HIV-negative mothers.
Papathakis
Peggy C
PC
Africa Centre for Health and Population Studies, Somekele, South Africa. ppatha@calpoly.edu
Rollins
Nigel C
NC
Chantry
Caroline J
CJ
Bennish
Michael L
ML
Brown
Kenneth H
KH
D000210:Acute-Phase Reaction; D000328:Adult; D001942:Breast Feeding; D005260:Female; D005492:Folic Acid / Q000097:blood; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000097:blood*; D006454:Hemoglobins / Q000032:analysis / Q000378:metabolism; D006801:Humans; D007774:Lactation / Q000097:blood*; D008137:Longitudinal Studies; D039382:Maternal Nutritional Physiological Phenomena / Q000502:physiology; D018977:Micronutrients / Q000097:blood* / Q000172:deficiency*; D009752:Nutritional Status; D049590:Postpartum Period / Q000097:blood; D011446:Prospective Studies; D012709:Serum Albumin / Q000378:metabolism; D019562:Viral Load; D014805:Vitamin B 12 / Q000097:blood; D015032:Zinc / Q000097:blood; D024502:alpha-Tocopherol / Q000097:blood
D006454:Hemoglobins; D018977:Micronutrients; D012709:Serum Albumin; D005492:Folic Acid; D024502:alpha-Tocopherol; D015032:Zinc; D014805:Vitamin B 12