The effects of vitamin A supplementation on the morbidity of children born to HIV-infected women.
What this study found
Vitamin A supplementation reduced overall morbidity through 18 months of age, with the clearest benefit for diarrhea-related outcomes. The odds ratio for all morbidity was 0.69 (0.48, 0.99), diarrhea was 0.71 (0.47, 1.08), diarrhea lasting 7 days was 0.62 (0.32, 1.20), and hospitalization for diarrhea was 0.23 (0.04, 1.20). Benefits were reported as larger among HIV-infected infants, while mortality was not reduced. Growth was not adversely affected; weight gain from 1 to 9 months was 4.42 kg in the vitamin A group versus 4.84 kg in the placebo group.
- Study & population
- Double-blind, randomized trial in infants born to HIV-infected women at King Edward VIII Hospital in Durban, South Africa.
- Intervention
- The active regimen was oral vitamin A as retinyl palmitate, given at 1 and 3 months as 50,000 IU, at 6 and 9 months as 100,000 IU, and at 12 and 15 months as 200,000 IU.
- Key limitation
- The vitamin A arm was small, with only 60 enrolled infants, and several outcome estimates had wide confidence intervals that crossed 1.
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Open PDFOriginal 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 trial of vitamin A supplementation was carried out in 118 offspring of HIV-infected women in Durban, South Africa. Those assigned to receive a supplement were given 50,000 IU of vitamin A at 1 and 3 months of age; 100,000 IU at 6 and 9 months; and 200,000 IU at 12 and 15 months. Morbidity in the past month was then recalled at each follow-up visit. Analysis was based on 806 child-months. RESULTS Among all children, the supplemented group had lower overall morbidity than the placebo group (OR = 0.69; 95% confidence interval [CI] = 0.48, 0.99). Among the 85 children of known HIV status (28 infected, 57 uninfected), morbidity associated with diarrhea was significantly reduced in the supplemented infected children (OR = 0.51; 95% CI = 0.27, 0.99), whereas no effect of supplementation on diarrheal morbidity was noted among the uninfected children. CONCLUSION In a population not generally vitamin A deficient, vitamin A supplementation for children of HIV-infected women appeared to be beneficial, reducing morbidity. The benefit was observed particularly for diarrhea among HIV-infected children.