Abstract
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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1935-1944 |
| Number of pages | 10 |
| Journal | AIDS |
| Volume | 16 |
| Issue number | 14 |
| DOIs | |
| State | Published - Sep 27 2002 |
| Externally published | Yes |
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Keywords
- Breastfeeding
- Death
- HIV infection
- Pregnancy
- Tanzania
- Vertical transmission
- Vitamin
ASJC Scopus subject areas
- Immunology and Allergy
- Immunology
Cite this
Randomized trial of vitamin supplements in relation to transmission of HIV-1 through breastfeeding and early child mortality. / Fawzi, Wafaie W.; Msamanga, Gernard I.; Hunter, David; Renjifo, Boris; Antelman, Gretchen; Bang, Heejung; Manji, Karim; Kapiga, Saidi; Mwakagile, Davis; Essex, Max; Spiegelman, Donna.
In: AIDS, Vol. 16, No. 14, 27.09.2002, p. 1935-1944.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Randomized trial of vitamin supplements in relation to transmission of HIV-1 through breastfeeding and early child mortality
AU - Fawzi, Wafaie W.
AU - Msamanga, Gernard I.
AU - Hunter, David
AU - Renjifo, Boris
AU - Antelman, Gretchen
AU - Bang, Heejung
AU - Manji, Karim
AU - Kapiga, Saidi
AU - Mwakagile, Davis
AU - Essex, Max
AU - Spiegelman, Donna
PY - 2002/9/27
Y1 - 2002/9/27
N2 - 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.
AB - 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.
KW - Breastfeeding
KW - Death
KW - HIV infection
KW - Pregnancy
KW - Tanzania
KW - Vertical transmission
KW - Vitamin
UR - http://www.scopus.com/inward/record.url?scp=0037183910&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0037183910&partnerID=8YFLogxK
U2 - 10.1097/00002030-200209270-00011
DO - 10.1097/00002030-200209270-00011
M3 - Article
C2 - 12351954
AN - SCOPUS:0037183910
VL - 16
SP - 1935
EP - 1944
JO - AIDS
JF - AIDS
SN - 0269-9370
IS - 14
ER -