Press Releases

2002 Releases

HIV-1 positive mothers taking vitamin A increase risk of transmitting HIV to newborns

For immediate release:  September 13, 2002 

Boston, MA— In a randomized trial of maternal vitamin supplements in relation to HIV-1 transmission and child health, researchers from the Harvard School of Public Health and the Muhimbili University College of Health Services in Dar es Salaam, Tanzania found that women taking vitamin A increased the risk of transmission of HIV-1 to their newborn child compared to mothers who did not take vitamin A. The study results appear in the September 27, 2002 issue of the journal AIDS.



In many regions of Africa between 15 and 30 percent of women attending prenatal care clinics are HIV-1 positive, and 20 to 45 percent of children born to HIV-1 positive mothers become infected through breastfeeding or during intrauterine or labor and delivery periods. Mother-to-child transmission of HIV-1 has been attributed in part to poor maternal micronutrient levels. Multivitamin supplementation has been viewed as a low-cost alternative in areas where antiretroviral and prophylactic drugs are not available.



Researchers randomly assigned 1,078 HIV-1 infected pregnant women in Tanzania to vitamin A, multivitamins excluding A (vitamins B, C, and E), multivitamins including A, or a placebo. Women received the supplements from approximately 20 weeks’ gestation and throughout lactation, and made monthly clinic visits to enable researchers to examine the effects of the supplements on HIV-1 transmission and on childhood mortality in the first two years of life. At two years of age, among the children whose mothers received vitamin A supplements, 42.4 percent were infected compared to 33.8 percent whose mothers were not given vitamin A.



Transmission through breastfeeding was defined as infection after six weeks of age among those who were not known to be infected previously. Although multivitamin use was not associated with a statistically significant reduction in transmission of HIV-1 through breastfeeding, it did significantly reduce the transmission via that route in sub-groups of mothers with low lymphocyte counts, low hemoglobin, high erythrocyte sedimentation and among low birth-weight babies. Multivitamin use reduced death and prolonged HIV-free survival significantly among children born to mothers with low nutritional and immunological status.



“Our findings give little encouragement for the use of vitamin A supplements in HIV-1 positive pregnant women,” said Wafaie Fawzi, lead author of the study and associate professor of nutrition and epidemiology at the Harvard School of Public Health. He added, “Multivitamin supplementation (excluding A) for nutritionally and immunologically compromised breastfeeding mothers reduced child mortality and transmission of HIV-1 through breastfeeding. It is important to consider providing these supplements to all pregnant HIV-positive women throughout pregnancy and lactation. It is also important to note that the findings should not raise concerns about ongoing child programs that provide vitamin A supplements starting at six months of age.”



The study was supported in part by the National Institute of Child Health and Human Development and the Fogarty International Center at the National Institutes of Health.