Randomized trial testing the effect of vitamin A supplementation on pregnancy outcomes and early mother-to-child HIV-1 transmission in Durban, South Africa. South African Vitamin A Study Group.

Important note: Information in this article was accurate in 2000. The state of the art may have changed since the publication date.

Randomized trial testing the effect of vitamin A supplementation on pregnancy outcomes and early mother-to-child HIV-1 transmission in Durban, South Africa. South African Vitamin A Study Group.

AIDS. 1999 Aug 20;13(12):1517-24. Unique Identifier : AIDSLINE MED/99392745
Coutsoudis A; Pillay K; Spooner E; Kuhn L; Coovadia HM; Department of Paediatrics and Child Health, University of Natal,; Africa Centre for Population Studies and Reproductive Health,; South Africa.

Abstract: OBJECTIVE: Poor vitamin A status has been associated with a higher risk for mother-to-child transmission of HIV-1 and there is contradictory evidence on the impact of vitamin A on perinatal outcome. We therefore assessed the effect of vitamin A supplementation to mothers on birth outcome and mother-to-child transmission of HIV-1. DESIGN AND METHODS: In Durban, South Africa 728 pregnant HIV infected women received either vitamin A (368) or placebo (360) in a randomized, double-blind trial. The vitamin A treatment consisted of a daily dose of 5000 IU retinyl palmitate and 30 mg beta-carotene during the third trimester of pregnancy and 200000 IU retinyl palmitate at delivery. HIV infection results were available on 632 children who were included in the Kaplan-Meier transmission analysis. Results are reported on mother-to-child transmission rates up to 3 months of age. RESULTS: There was no difference in the risk of HIV infection by 3 months of age between the vitamin A [20.3%; 95% confidence interval (CI), 15.7-24.9] and placebo groups (22.3%; 95% CI, 17.5-27.1), nor were there differences in foetal or infant mortality rates between the two groups. Women receiving vitamin A supplement were, however, less likely to have a preterm delivery (11.4% in the vitamin A and 17.4% in the placebo group; P = 0.03) and among the 80 preterm deliveries, those assigned to the vitamin A group were less likely to be infected (17.9%; 95% CI, 3.5-32.2) than those assigned to the placebo group (33.8%; 95% CI, 19.8-47.8). CONCLUSION: Vitamin A supplementation, a low-cost intervention, does not appear to be effective in reducing overall mother-to-child transmission of HIV; however, its potential for reducing the incidence of preterm births, and the risk of mother-to-child transmission of HIV in these infants needs further investigation.

Keywords: CLINICAL TRIAL JOURNAL ARTICLE RANDOMIZED CONTROLLED TRIAL Adult Beta Carotene/THERAPEUTIC USE Dietary Supplements Disease Transmission, Vertical/*PREVENTION & CONTROL Double-Blind Method Female Human HIV Infections/MORTALITY/*PREVENTION & CONTROL/*TRANSMISSION HIV-1/ISOLATION & PURIF Infant Infant Mortality Infant, Newborn Infant, Premature Male Pregnancy Pregnancy Complications, Infectious/*PREVENTION & CONTROL/ VIROLOGY Pregnancy Outcome Pregnancy Trimester, Third South Africa Support, Non-U.S. Gov't Vitamin A/ANALOGS & DERIVATIVES/*THERAPEUTIC USE

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