Effect of prenatal vitamin supplementation on lower-genital levels of HIV type 1 and interleukin type 1 beta at 36 weeks of gestation

Clin Infect Dis. 2004 Mar 1;38(5):716-22. doi: 10.1086/381673. Epub 2004 Feb 17.

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-1 beta (IL-1 beta ), 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.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Ascorbic Acid / pharmacology
  • Dietary Supplements
  • Female
  • HIV Infections / metabolism
  • HIV Infections / virology
  • HIV-1 / drug effects*
  • HIV-1 / physiology
  • Humans
  • Interleukin-1 / metabolism*
  • Pregnancy
  • Pregnancy Complications, Infectious
  • Viral Load
  • Vitamin B Complex / pharmacology
  • Vitamin E / pharmacology
  • Vitamins / pharmacology*

Substances

  • Interleukin-1
  • Vitamins
  • Vitamin B Complex
  • Vitamin E
  • Ascorbic Acid