The Associated Press - 8 Aug 95

People who lack enough Vitamin A, both otherwise healthy people and the HIV-infected, are vulnerable to numerous diseases and even death. Whether increased doses of Vitamin A in people who already have enough in their diet is of benefit is controversial.

But the first study of Vitamin A in HIV-infected babies, in a South African hospital whose patients don't lack the nutrient, found moderately large doses helped infants fight off AIDS-related illnesses, especially dangerous diarrhea, Natal University researchers report. The study was published in Wednesday's American Journal of Public Health.

The results look "very plausible," and suggest "that Vitamin A might even have applicability in the United States," said Dr. Reynaldo Martorell, a public health expert at Emory University who independently reviewed the study.

Doctors in Durban, South Africa, separated 118 babies born to HIV-infected women into two groups. Half the babies received doses of Vitamin A at ages 1 to 3 months, 6 to 9 months and 12 to 15 months. The other babies got placebos. Eighty-five of the infants were later found to be HIV-infected; they were similarly distributed between the vitamin and placebo groups.

All the children who received Vitamin A supplements, regardless of HIV status, had fewer illnesses, from rashes to respiratory infections. The vitamin-treated babies had 152 cases of illness; the untreated, 177.

But the Vitamin A made a much larger difference in HIV-infected children who suffered diarrhea, a major child killer, said study author Anna Coutsoudis, a Natal University pediatrics professor.

The vitamin supplements reduced diarrhea cases by 49 percent among HIV-infected babies, and lowered diarrhea cases that last seven or more days by 56 percent, Coutsoudis reported. Also, diarrhea-caused hospital stays were 77 percent lower among supplemented HIV babies.

In babies who did not have HIV, the Vitamin A made no difference in diarrhea, a fairly common illness among children in developing countries.

The study followed the babies just through age 18 months, so Coutsoudis couldn't say if Vitamin A would help them live longer.

Currently, doctors have little to offer HIV-infected children, and the drugs that are available are expensive and have often-severe side effects, Martorell said.

"If Vitamin A were to be effective, then it would provide a cheaper means of trying to lessen the burden of HIV infection," he said.

But he cautioned that the South African babies took high enough doses that they had to be closely monitored -- because too much Vitamin A is highly toxic. No one should try Vitamin A supplementation for HIV on their own -- and Coutsoudis' findings must be replicated before doctors routinely offer it to AIDS babies, he cautioned.

Coutsoudis couldn't prove why the Vitamin A helped. But Martorell theorized that HIV depresses the amount of Vitamin A naturally in the blood, much as the measles virus does when it frequently kills Vitamin A-deficient children in developing countries.

Copyright 1995/The Associated Press. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Permissions Desk, The Associated Press, 50 Rockefeller Plaza, New York, NY 10020.

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Copyright © 1995 - Associated Press. Reproduction of this article (other than one copy for personal reference) must be cleared through the AP Permissions Desk.

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