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Effect of Prenatal Vitamin Supplementation on Lower-Genital Levels of HIV Type 1 and Interleukin Type 1β at 36 Weeks of Gestation

Wafaie Fawzi, Gernard Msamanga, Gretchen Antelman, Chong Xu, Ellen Hertzmark, Donna Spiegelman, David Hunter and Deborah Anderson
Clinical Infectious Diseases
Vol. 38, No. 5 (Mar. 1, 2004), pp. 716-722
Published by: Oxford University Press
Stable URL: http://www.jstor.org/stable/4483801
Page Count: 7
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Effect of Prenatal Vitamin Supplementation on Lower-Genital Levels of HIV Type 1 and Interleukin Type 1β at 36 Weeks of Gestation
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Abstract

Micronutrient status has been associated with shedding of human immunodeficiency virus type 1 (HIV-1) in the lower-genital tract in observational studies. We examined the effect of vitamin supplements on genital HIV-1 shedding and interleukin-1β (IL-1β), a cytokine marker of vaginal inflammation and promotion of HIV-1 infection. Consenting HIV-1-infected pregnant women were randomized to receive daily supplementation with vitamin A and/or multivitamins B-complex, C, and E with use of a factorial design. Cervicovaginal lavage (CVL) specimens were obtained shortly before delivery. Significantly more women who received vitamin A had detectable levels of HIV-1 in CVL (74.8%), compared with those who did not receive vitamin A (65.1%) (P = .04, by multivariate analysis). Multivitamin B-complex, C, and E had no effect on the risk of viral shedding. Our results raise concern about the use of vitamin A supplements by HIV-1-infected women. Use of prenatal multivitamin supplements (including vitamins B-complex, C, and E) should be continued despite the lack of effect on HIV-1 transmission because of previously reported positive effects on maternal health and pregnancy outcomes.

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