Effect of prenatal vitamin supplementation on lower-genital levels of HIV type 1 and interleukin type 1β at 36 weeks of gestation
Effect of prenatal vitamin supplementation on lower-genital levels of HIV type 1 and interleukin type 1β at 36 weeks of gestation
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DOI：
10.1086/381673
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发表时间：
2004-03-01
影响因子：
11.8
通讯作者：
Anderson, D
中科院分区：
文献类型：
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作者：
Fawzi, W;Msamanga, G;Anderson, D
观察性研究表明，微量营养素状况与下生殖道 1 型人类免疫缺陷病毒 (HIV-1) 的脱落有关。我们研究了维生素补充剂对生殖器 HIV-1 脱落和白细胞介素 1β (IL-1β) 的影响，IL-1β 是阴道炎症和促进 HIV-1 感染的细胞因子标记物。采用析因设计，同意的 HIV-1 感染孕妇被随机每天补充维生素 A 和/或复合维生素 B、C 和 E。宫颈阴道灌洗（CVL）标本是在分娩前不久获得的。与未接受维生素 A 的女性 (65.1%) 相比，接受维生素 A 治疗的女性 CVL 中可检测到 HIV-1 水平的女性 (74.8%) 明显增多（多变量分析，P = 0.04）。复合维生素 B、C 和 E 对病毒脱落的风险没有影响。我们的研究结果引起了人们对 HIV-1 感染女性使用维生素 A 补充剂的担忧。尽管对 HIV-1 传播缺乏影响，但仍应继续使用产前多种维生素补充剂（包括复合维生素 B、C 和 E），因为之前报道过对孕产妇健康和妊娠结局有积极影响。
Micronutrient status has been associated with shedding of human immunodeficiency virus type 1 (HIV-1) in the lower-genital tract in observational studies. We examined the effect of vitamin supplements on genital HIV-1 shedding and interleukin-1beta (IL-1beta), a cytokine marker of vaginal inflammation and promotion of HIV-1 infection. Consenting HIV-1-infected pregnant women were randomized to receive daily supplementation with vitamin A and/or multivitamins B-complex, C, and E with use of a factorial design. Cervicovaginal lavage (CVL) specimens were obtained shortly before delivery. Significantly more women who received vitamin A had detectable levels of HIV-1 in CVL (74.8%), compared with those who did not receive vitamin A (65.1%) (P = .04, by multivariate analysis). Multivitamin B-complex, C, and E had no effect on the risk of viral shedding. Our results raise concern about the use of vitamin A supplements by HIV-1-infected women. Use of prenatal multivitamin supplements (including vitamins B-complex, C, and E) should be continued despite the lack of effect on HIV-1 transmission because of previously reported positive effects on maternal health and pregnancy outcomes.