The effects of vitamin A supplementation on the morbidity of children born to HIV-infected women.

American journal of public health
Q1
Aug 1995
Citations:213
Influential Citations:8
Interventional (Human) Studies
88
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Methods
Double‑blind, randomized, placebo‑controlled trial conducted at King Edward VIII Hospital, Durban, South Africa (April 1991–November 1993); full‑term infants born to HIV‑infected mothers; n=60 assigned to Vitamin A and n=58 to placebo; both sexes; HIV infection status determined by HIV antibody testing at 15 months; follow‑up to 18 months.
Intervention
Vitamin A (retinyl palmitate) supplementation given orally to infants born to HIV‑infected women: 50,000 IU at 1 and 3 months; 100,000 IU at 6 and 9 months. Delivered as drops (1) and amber gelatin capsules (6 and 9 months) with placebo matching in appearance; supplementation stopped at 9 months; follow-up through 18 months of age.
Results
Vitamin A supplementation reduced overall morbidity during the first 18 months (all morbidity: 36.5 vs 45.4 episodes per 100 child‑months; OR 0.69; 95% CI 0.48–0.99). Diarrhea showed a notable reduction (OR 0.71; 95% CI 0.47–1.08); in HIV‑infected infants diarrhea incidence fell from 35.1 to 21.6 episodes per 100 child‑months (OR 0.51; 95% CI 0.27–0.99). Diarrhea lasting ≥7 days also tended lower (OR 0.44; 95% CI 0.17–1.18). Authors conclude postnatal Vitamin A supplementation reduces morbidity in HIV‑exposed infants, with stronger benefits among HIV‑infected children, and that the intervention is inexpensive and feasible in resource‑limited settings.
Limitations
Small sample size; some infants had unknown HIV status; considerable loss to follow‑up and deaths; incomplete outcome data may limit precision; results may be influenced by unmeasured confounders.

Abstract

OBJECTIVE The effects of vitamin A supplementation on morbidity of children born to human immunodeficiency virus (HIV)-infected women were evaluated in a population where vitamin A deficiency is not endemic. METHODS A randomized, placebo-controlled...