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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Randomized trial of vitamin supplements in relation to transmission of HIV-1 through breastfeeding and early child mortality
AIDS, Volume 16, No. 14, Year 2002
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Description
Background: HIV-1 transmission through breastfeeding is a global problem and has been associated with poor maternal micronutrient status. Methods: A total of 1078 HIV-infected pregnant women from Tanzania were randomly assigned to vitamin A or multivitamins excluding A from approximately 20 weeks' gestation and throughout lactation. Results: Multivitamins excluding A had no effect on the total risk of HIV-1 transmission (RR 1.04, 95% Cl 0.82-1.32, P= 0.76). Vitamin A increased the risk of transmission (RR 1.38, 95% Cl 1.09-1.76, P = 0.009). Multivitamins were associated with non-statistically significant reductions in transmission through breastfeeding, and mortality by 24 months among those alive and not infected at 6 weeks. Multivitamins significantly reduced breastfeeding transmission in infants of mothers with low baseline lymphocyte counts (RR 0.37; 95% Cl 0.16-0.85, P = 0.02) compared with infants of mothers with higher counts (RR 0.99, 95% Cl 0.68-1.45, P = 0.97; P-for-interaction 0.03). Multivitamins also protected against transmission among mothers with a high erythrocyte sedimentation rate (P-for-interaction 0.06), low hemoglobin (P-for-interaction 0.06), and low birthweight babies (P-for-interaction 0.04). Multivitamins reduced death and prolonged HIV-free survival significantly among children born to women with low maternal immunological or nutritional status. Vitamin A alone increased breastfeeding transmission but had no effect on mortality by 24 months. Conclusion: Vitamin A increased the risk of HIV-1 transmission. Multivitamin (B, C, and E) supplementation of breastfeeding mothers reduced child mortality and HIV-1 transmission through breastfeeding among immunologically and nutritionally compromised women. The provision of these supplements to HIV-infected lactating women should be considered. © 2002 Lippincott Williams & Wilkins.
Authors & Co-Authors
Fawzi, Wafaie W.
United States, Boston
Harvard T.h. Chan School of Public Health
Msamanga, Gernard I.
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Hunter, D. J.
United States, Boston
Harvard T.h. Chan School of Public Health
Renjifo, Boris R.
United States, Boston
Harvard T.h. Chan School of Public Health
Antelman, Gretchen
United States, Boston
Harvard T.h. Chan School of Public Health
Bang, Heejung
United States, Boston
Harvard T.h. Chan School of Public Health
Manji, Karim Premji
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Kapiga, Saidi Hussein
United States, Boston
Harvard T.h. Chan School of Public Health
Mwakagile, Davis S.M.
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Essex, Max E.
United States, Boston
Harvard T.h. Chan School of Public Health
Spiegelman, Donna L.
United States, Boston
Harvard T.h. Chan School of Public Health
Statistics
Citations: 240
Authors: 11
Affiliations: 2
Identifiers
Doi:
10.1097/00002030-200209270-00011
Research Areas
Infectious Diseases
Maternal And Child Health
Study Locations
Tanzania
Participants Gender
Female