Multivitamin Supplements Delay Progression of HIV Among Women
For immediate release: June 30, 2004
Boston, MA— A simple daily regimen of multivitamins can significantly delay the progress of the AIDS virus according to the results of a study of HIV infected women in Tanzania. Researchers from the Harvard School of Public Health and the Muhimbili University College of Health Services in Dar es Salaam, found that women taking multivitamins (vitamins B-complex, C and E) significantly delayed the progression of HIV disease compared to those in the study who received the placebo. The study results appear in the July 1, 2004 issue of The New England Journal of Medicine.
By the end of 2003, 40 million people worldwide were infected with HIV, with fewer than 8 percent of the 6 million patients with advanced symptoms of the disease who were eligible for antiretroviral drug therapy receiving it. The “Treat 3 million by 2005” initiative by the World Health Organization (WHO) is designed to increase access to treatment. According to this plan, and country-specific standards of care, individuals with advanced disease will receive antiretroviral therapy, while those in earlier stages will be monitored and provided supportive care.
The researchers randomly assigned 1,078 HIV-infected pregnant women in Tanzania to receive a daily dose of one of four regimens: vitamin A alone, multivitamins excluding A (with vitamin B complex and vitamins C and E), multivitamins containing vitamin A, or a placebo. The women were enrolled over a two-year period beginning in April 1995 and were followed until the end of the study in August of 2003. All women received standard doses of antenatal folic acid and iron and all children received 6-monthly doses of vitamin A, as per standard of care in Tanzania. Antiretroviral therapy was not available at the time of the study to the majority of women in Tanzania, including those who were eligible for participation in the study.
During the course of the study 299 of the 1078 women either died from AIDS-related causes or progressed to WHO stage 4 (equivalent to AIDS): Among the 271 women who received multivitamins, 67 (24.7 percent) progressed to WHO stage 4 or died of AIDS-related causes; among women who received multivitamins with vitamin A the total was 70 (26.1 (percent) of the 268; for those who received vitamin A alone it was 79 (29 percent) and of 272 who received the placebo it was 83 (31.1 percent) who progressed to WHO stage 4 or died from AIDS-related causes. Additionally, women in the study who took multivitamins had higher CD4 immune cell counts, lower viral loads, and reduced complications of HIV infection including oral thrush, oral ulcers, difficulty in swallowing, diarrhea and fatigue.
“Our findings should encourage the use of multivitamin supplements as supportive care to those infected with HIV. As antiretroviral therapy becomes available in less developed countries many HIV-infected persons will be identified who do not meet the international guidelines for initiation of therapy. Our data suggest that multivitamins delay the onset of disease progression and thus extend the time until such therapy is necessary.” 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 is inexpensive, $15 per person per year. Introducing these supplements would enhance compliance with monitoring prior to clinical eligibility for antiretroviral drugs, preserve these drugs for later stages of the disease, avert adverse events associated with them, and result in better quality of life among HIV infected persons and significant treatment-related cost savings.”
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.
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