Maternal vitamin A status and mother-to-child transmission of HIV in West Africa

• Published in: AIDS (London) Vol. 14; no. 7; pp. 908 - 910
• Main Authors: Castetbon, Katia, Manigart, Olivier, Bonard, Dominique, Thomas, Marie-Josée, Dumon, Marie-France, Malvy, Denis, Perre, Philippe Van de, Dabis, François
• Format: Journal Article
• Language: English
• Published: 05.05.2000
• Subjects: Human immunodeficiency virus
• ISSN: 0269-9370
• DOI: 10.1097/00002030-200005050-00026

Observational studies in Malawi and the United States have shown an association between low plasma vitamin A status during pregnancy and an increased risk of mother-to-child transmission (MTCT) of HIV. However, this observation was not confirmed in more recent American studies. Trials evaluating the efficacy of retinol and carotene supplementation in reducing MTCT have been initiated in Africa. According to the currently available results, vitamin A supplementation does not seem to have any significant effect in reducing MTCT. A biased estimation of the effect of vitamin A supplementation, if any, should not be ruled out in those studies. Also, vitamin A deficit in HIV-infected women is multifactorial: intake reduction; impaired release of retinol binding protein (RBP); and excess urinary loss of retinol. These factors could act differently according to the background of endemic vitamin A deficit and the stage of HIV disease. Observations in different settings could therefore be useful to obtain a better understanding of the relationship between vitamin A and MTCT of HIV. This study was performed within the DITRAME ANRS 049a trial, which was placebo-controlled and evaluated the efficacy of a short regimen of zidovudine (ZDV) in reducing MTCT in breastfed children in Abidjan (Cote d'Ivoire) and Bobo-Dioulasso (Burkina Faso).