Maternal serum vitamin A levels are not associated with mother-to-child transmission of HIV-1 in the United States
Maternal serum vitamin A levels are not associated with mother-to-child transmission of HIV-1 in the United States
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DOI：
10.1097/00042560-199704010-00003
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发表时间：
1997-04-01
期刊：
影响因子：
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通讯作者：
Blaner, WS
中科院分区：
文献类型：
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作者：
Burger, H;Kovacs, A;Blaner, WS
在对非洲妇女的研究中，HIV-1母婴传播与母亲维生素A状况有关。这一发现提出了一个问题，即补充维生素A是否有助于减少在美国和世界范围内的传播。然而，在工业化国家，感染hiv -1的孕妇的维生素A营养状况和维生素A水平与垂直传播的关系都是未知的。此外，维生素A是致畸的，在怀孕期间补充维生素A会导致出生缺陷。为了调查美国孕妇血清中维生素A（视黄醇）和其他三种微量营养素水平是否与HIV-1垂直传播相关，我们研究了95名感染HIV-1的孕妇，并跟踪她们的婴儿以确定是否发生了传播。在纽约和洛杉矶大都市地区的95名hiv -1感染妇女的妊娠晚期获得血清。这两个队列的建立是为了研究HIV-1的垂直传播，并反映美国女性HIV-1感染的种族、民族和社会经济地位。我们使用反相高效液相色谱法测量了母亲血清中维生素A（视黄醇）和其他三种微量营养素，维生素E （α -生育酚）、β -胡萝卜素和番茄红素的水平，并使用病毒培养和聚合酶链反应测定了婴儿的HIV-1感染状况。95名妇女中有16名将HIV-1传染给了她们的婴儿。数据的统计分析表明，妊娠晚期母亲血清视黄醇水平低与HIV-1母婴传播无关。这些女性的视黄醇水平都没有低到出现维生素A缺乏症的临床症状。研究人员还测量了血清中α -生育酚、β -胡萝卜素和番茄红素的水平，这三种微量营养素可以起到抗氧化剂和增强免疫功能的作用。数据的统计分析显示，这三种微量营养素的水平与HIV-1垂直传播没有关联。从美国95名妇女获得的数据分析表明，维生素A缺乏症很少见，血清视黄醇水平与HIV-1垂直传播的风险无关。鉴于在怀孕期间补充维生素A会产生致畸作用，在维生素A缺乏不构成公共卫生问题的国家，不应建议感染艾滋病毒的怀孕妇女额外补充维生素A。
HIV-1 transmission from mother to child has been associated with maternal vitamin A status in studies of women living in Africa. This finding has raised the question of whether vitamin A supplementation might help reduce transmission in the United States as well as worldwide. In industrialized nations, however, both the vitamin A nutritional status of HIV-1-infected pregnant women and the association of vitamin A levels with vertical transmission were unknown. Futhermore, vitamin A is teratogenic, and supplements during pregnancy have caused birth defects. To investigate whether maternal serum levels of vitamin A (retinol) and three other micronutrients correlate with vertical transmission of HIV-1 in the United States, we studied 95 HIV-1-infected pregnant women and followed their infants to determine whether transmission occurred. Sera were obtained during the third trimester of pregnancy from 95 HIV-1-infected women living in the New York and Los Angeles metropolitan areas. The two cohorts were established to study vertical transmission of HIV-1 and to reflect the racial, ethnic, and socioeconomic status of HIV-1-infected in women in the United States. We measured serum levels of vitamin A (retinol) and three other micronutrients, vitamin E (alpha-tocopherol), beta-carotene, and lycopene, in the mothers using reverse-phase high-performance liquid chromatography and determined the HIV-1 infection status of their infants using virus cultivation and polymerase chain reaction. Sixteen of the 95 women transmitted HIV-1 to their infants. Statistical analysis of the data indicated that low maternal serum retinol levels during the third trimester of pregnancy were not associated with mother-to-child transmission of HIV-1. None of the women had retinol levels so low as to have clinical symptoms of vitamin A deficiency. The serum levels of alpha-tocopherol, beta-carotene, and lycopene, three micronutrients that act as antioxidants and enhance immune function, were also measured. Statistical analysis of the data revealed no association of the levels of these three micronutrients with vertical transmission of HIV-1. Analysis of the data obtained from 95 women in the United States indicates that vitamin A deficiency is rare, and serum retinol levels are not associated with risk of vertical HIV-1 transmission. In view of the teratogenic effects of vitamin A when taken as a supplement during pregnancy, pregnant HIV-1-infected women living in nations where vitamin A deficiency is not a public health problem should not be advised to take extra vitamin A supplements.