Randomized trial of vitamin supplements in relation to transmission of HIV-1 through breastfeeding and early child mortality

Study answer

What this study found

Vitamin A supplementation was harmful, increasing HIV transmission through breastfeeding and raising total infant HIV infection by 24 months, while multivitamins without vitamin A did not improve overall transmission or survival but showed benefit in some higher-risk subgroups. In the vitamin A arm, total HIV infection by 24 months was higher (RR 1.38, 1.09-1.76; P=0.009), with no mortality benefit (RR 1.03, 0.66-1.62; P=0.89). In the multivitamins without vitamin A arm, overall total HIV infection was unchanged (RR 1.04, 0.82-1.32; P=0.76) and breastfeeding transmission was not…

Study & population

Randomized placebo-controlled trial in HIV-infected pregnant women attending public antenatal clinics in Dar es Salaam, Tanzania.

Intervention

Three active daily oral regimens were compared with identical placebo from enrollment through pregnancy and lactation: vitamin A alone (30 mg beta-carotene plus 5000 IU preformed vitamin A), multivitamins without vitamin A (B1 20 mg, B2 20 mg, B6 25 mg, niacin 100 mg, B12 50 µg, vitamin C 500 mg, vitamin E 30 mg,…

Key limitation

The multivitamin findings were driven largely by subgroup and time-varying analyses rather than the primary overall comparisons, increasing the risk of chance findings from multiple testing.

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Original abstract