Details

Autor(en) / Beteiligte

• Fawzi, Wafaie W
• Msamanga, Gernard I
• Spiegelman, Donna
• Urassa, Ernest JN
• McGrath, Nuala
• Mwakagile, Davis
• Antelman, Gretchen
• Mbise, Roger
• Kapiga, Saidi
• Willett, Walter
• Hunter, David J
• Herrera, Guillermo

Titel

Randomised trial of effects of vitamin supplements on pregnancy outcomes and T cell counts in HIV-1-infected women in Tanzania

Ist Teil von

• The Lancet (British edition), 1998-05, Vol.351 (9114), p.1477-1482

Ort / Verlag

London: Elsevier Ltd

Erscheinungsjahr

1998

Link zum Volltext

Quelle

EBSCOhost Business Source Ultimate

Beschreibungen/Notizen

• In HIV-1-infected women, poor micronutrient status has been associated with faster progression of HIV-1 disease and adverse birth outcomes. We assessed the effects of vitamin A and multivitamins on birth outcomes in such women. In Tanzania, 1075 HIV-1-infected pregnant women at between 12 and 27 weeks' gestation received placebo (n=267), vitamin A (n=269), multivitamins excluding vitamin A (n=269), or multivitamins including vitamin A (n=270) in a randomised, double-blind, placebo-controlled trial with a 2×2 factorial design. We measured the effects of multivitamins and vitamin A on birth outcomes and counts of T lymphocyte subsets. We did analyses by intention to treat. 30 fetal deaths occurred among women assigned multivitamins compared with 49 among those not on multivitamins (relative risk 0·61 [95% CI 0·39–0·94] p=0·02). Multivitamin supplementation decreased the risk of low birthweight (<2500 g) by 44% (0·56 [0·38–0·82] p=0·003), severe preterm birth (<34 weeks of gestation) by 39% (0·61 [0·38–0·96] p=0·03), and small size for gestational age at birth by 43% (0·57 [0·39–0·82] p=0·002). Vitamin A supplementation had no significant effect on these variables. Multivitamins, but not vitamin A, resulted in a significant increase in CD4, CD8, and CD3 counts. Multivitamin supplementation is a low-cost way of substantially decreasing adverse pregnancy outcomes and increasing T-cell counts in HIV-1-infected women. The clinical relevance of our findings for vertical transmission and clinical progression of HIV-1 disease is yet to be ascertained.