Skip to main content
SpringerLink
Log in

Vitamin Supplements and Disease Resistance in HIV-Infected Women and Children

  • Chapter
  • First Online:
Book cover Dietary Components and Immune Function

Part of the book series: Nutrition and Health ((NH))

  • 2062 Accesses

Key Points

Multivitamin supplements (including vitamins B, C, and E) can improve immune parameters, pregnancy outcomes, and child growth and health among HIV-infected women and children. Vitamin A supplementation is beneficial against morbidity and mortality when given to children, but increases the risk of mother-to-child HIV transmission when given to pregnant, HIV-infected women. The majority of research pertaining to vitamins and HIV disease progression has been conducted in patients not receiving antiretrovial therapy, and so further research is urgently needed to examine the efficacy of nutritional interventions as coadjuvants of antiretrovial therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. de Onis M, Blossner M, Borghi E, Morris R, Frongillo E (2004) Methodology for estimating regional and global trends of child malnutrition. Int J Epid 33:1260–1270

    Article  Google Scholar 

  2. Micronutrient Initiative, UNICEF (2004) Vitamin and mineral deficiency: a global damage assessment report. Micronutrient Initiative, Ottawa, Canada

    Google Scholar 

  3. Keusch G, Farthing M (1990) Nutritional aspects of AIDS. Annu Rev Nutr 10:475–501

    Article  PubMed  CAS  Google Scholar 

  4. Semba R, Caiaffa W, Graham N, Cohn S, Vlahov D (1995) Vitamin A deficiency and wasting as predictors of mortality in human immunodeficiency virus-infected injection drug users. J Infect Dis 171:1196–1202

    Article  PubMed  CAS  Google Scholar 

  5. Tang A, Graham N, Semba R, Saah A (1997) Association between serum vitamin A and E levels and HIV-1 disease progression. AIDS 11:613–620

    Article  PubMed  CAS  Google Scholar 

  6. Tang A, Graham N, Chandra R, Saah A (1997) Low serum vitamin B-12 concentrations are associated with faster human immunodeficiency virus type 1 (HIV-1) disease progression. J Nutr 127:345–351

    PubMed  CAS  Google Scholar 

  7. Teichmann J, Stephan E, Discher T, Lange U, Federlin K, Stracke H, Friese G, Lohmeyer J, Bretzel R (2000) Changes in calciotropic hormones and biochemical markers of bone metabolism in patients with human immunodeficiency virus infection. Metabolism 49:1134–1139

    Article  PubMed  CAS  Google Scholar 

  8. Teichmann J, Stephan E, Lange U, Discher T, Friese G, Lohmeyer J, Stracke H, Bretzel R (2003) Osteopenia in HIV-infected women prior to highly active antiretroviral therapy. J Infect 46:221–227

    Article  PubMed  CAS  Google Scholar 

  9. Haug C, Muller F, Aukrust P, Froland S (1994) Subnormal serum concentration of 1, 25-vitamin D in human immunodeficiency virus infection: correlation with degree of immune deficiency and survival. J Infect Dis 169:889–893

    Article  PubMed  CAS  Google Scholar 

  10. Stephensen C, Gildengorin G (2000) Serum retinol, the acute phase response, and the apparent misclassification of vitamin A status in the third National Health and Nutrition Examination Survey. Am J Clin Nutr 72:1170–1178

    PubMed  CAS  Google Scholar 

  11. Abrams B, Duncan D, Hertz-Picciotto I (1993) A prospective study of dietary intake and acquired immune deficiency syndrome in HIV-seropositive homosexual men. J Acquir Immune Defic Syndr 6:949–958

    PubMed  CAS  Google Scholar 

  12. Food and Nutrition Board, and Institute of Medicine. (2001) Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. National Academy Press, Washington, DC

    Google Scholar 

  13. Tang A, Graham N, Kirby A, McCall A, Willett W, Saah A (1993) Dietary micronutrient intake and risk progression to acquired immunodeficiency syndrome (AIDS) in human immunodeficiency virus type 1 (HIV-1)-infected homosexual men. Am J Epidemiol 138:1–15

    Google Scholar 

  14. Kanter A, Spencer D, Steinberg M, Soltysik R, Yarnold P, Graham N (1999) Supplemental vitamin B and progression to AIDS and death in black South African patients infected with HIV. J Acquir Immune Defic Syndr 21:252–253

    Article  PubMed  CAS  Google Scholar 

  15. Tang A, Graham N, Saah A (1996) Effects of micronutrient intake on survival in human immunodeficiency virus type 1 infection. Am J Epidemiol 143:1244–1256

    Article  PubMed  CAS  Google Scholar 

  16. Coodley G, Nelson H, Loveless M, Folk C (1993) Beta-carotene in HIV infection. J Acquir Immune Defic Syndr 6:272–276

    PubMed  CAS  Google Scholar 

  17. Nimmagadda A, Burri B, Neidlinger T, O’Brien W, Goetz M (1998) Effect of oral beta-carotene supplementation on plasma human immunodeficiency virus (HIV) RNA levels and CD4+ cell counts in HIV-infected patients. Clin Infect Dis 27:1311–1313

    Article  PubMed  CAS  Google Scholar 

  18. Coodley G, Coodley M, Lusk R, Green T, Bakke A, Wilson D, Wachenheim D, Sexton G, Salveson C (1996) Beta-carotene in HIV infection: an extended evaluation. AIDS 10:967–973

    Article  PubMed  CAS  Google Scholar 

  19. Kelly P, Musonda R, Kafwembe E, Kaetano L, Keane E, Farthing M (1999) Micronutrient supplementation in the AIDS diarrhoea-wasting syndrome in Zambia: a randomized controlled trial. AIDS 13:495–500

    Article  PubMed  CAS  Google Scholar 

  20. Kelly P, Katubulushi M, Todd J, Banda R, Yambayamba V, Fwoloshi M, Zulu I, Kafwebe E, Yavwa F, Sanderson I, Tomkins A (2008) Micronutrient supplementation has limited effects on intestinal infectious disease and mortality in a Zambian population of mixed HIV status: a cluster randomized trial. Am J Clin Nutr 88:1010–1017

    PubMed  CAS  Google Scholar 

  21. Jiamton S, Pepin J, Suttent R, Filteau S, Mahakkanukrauh B, Hanshaoworakul W, Chaisilwattana P, Suthipinittharm P, Shetty P, Jaffar S (2003) A randomized trial of the impact of multiple micronutrient supplementation on mortality among HIV-infected individuals living in Bangkok. AIDS 17:2461–2469

    Article  PubMed  CAS  Google Scholar 

  22. Food and Nutrition Board, and Institute of Medicine. (1998) Dietary reference intakes for thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. National Academy Press, Washington, DC

    Google Scholar 

  23. Food and Nutrition Board, and Institute of Medicine. (2000) Dietary reference intakes for vitamin C, vitamin E, selenium, and carotenoids. National Academy Press, Washington, DC

    Google Scholar 

  24. Fawzi W, Msamanga G, Spiegelman D, Wei R, Kapiga S, Villamor E, Mwakagile D, Mugusi F, Hertzmark E, Essex M, Hunter D (2004) A randomized trial of multivitamin supplements and HIV disease progression and mortality. N Engl J Med 351:23–32

    Article  PubMed  CAS  Google Scholar 

  25. Villamor E, Saathoff E, Manji K, Msamanga G, Hunter D, Fawzi W (2005) Vitamin supplements, socioeconomic status, and morbidity events as predictors of wasting in HIV-infected women from Tanzania. Am J Clin Nutr 82:857–865

    PubMed  CAS  Google Scholar 

  26. Fawzi W, Msamang G, Kupka R, Spiegelman D, Villamor E, Mugusi F, Wei R, Hunter D (2007) Multivitamin supplementation improves hematologic status in HIV-infected women and their children in Tanzania. Am J Clin Nutr 85:1335–1343

    PubMed  CAS  Google Scholar 

  27. McClelland R, Baeten J, Overbaugh J, Richardson B, Mandaliya K, Emery S, Lavreys L, Ndinya-Achola J, Bankson D, Bwayo J, Kreiss J (2004) Micronutrient supplementation increases genital tract shedding of HIV-1 in women: results of a randomized trial. J Acquir Immune Defic Syndr 37:1657–1663

    Article  PubMed  CAS  Google Scholar 

  28. Meydani S, Ribaya-Mercado J, Russell R, Sahyoun N, Morrow F, Gershoff S (1991) Vitamin B-6 deficiency impairs interleukin 2 production and lymphocyte proliferation in elderly adults. Am J Clin Nutr 53:1275–1280

    PubMed  CAS  Google Scholar 

  29. Bendich A, Cohen M (1988) B vitamins: effects on specific and nonspecific immune responses. In: Chandra RK (ed) Nutrition and immunology. Alan R. Liss, New York, pp 101–123

    Google Scholar 

  30. Bendich A, Cohen M (1988) Antioxidant vitamins and immune responses. In: Chandra RK (ed) Nutrition and immunology. Alan R. Liss, New York, pp 125–147

    Google Scholar 

  31. Hemila H (1997) Vitamin C and infectious diseases. In: Packer L, Fuchs J (eds) Vitamin C in health and disease. Marcel Dekker, Inc, New York

    Google Scholar 

  32. Schreck R, Rieber P, Baeuerle P (1991) Reactive oxygen intermediates as apparently widely used messengers in the activation of the NF-kB transcription factor and HIV-1. EMBO J 10:2247–2258

    PubMed  CAS  Google Scholar 

  33. Allard J, Aghdassi E, Chau J, Tam C, Kovacs C, Salit I, Walmsley S (1998) Effects of vitamin E and C supplementation on oxidative stress and viral load in HIV-infected subjects. AIDS 12:1653–1659

    Article  PubMed  CAS  Google Scholar 

  34. Coutsoudis A, Pillay K, Spooner E, Kuhn L, Coovadia H (1999) Randomized trial testing the effect of vitamin A supplementation on pregnancy outcomes and early mother-to-child HIV-1 transmission in Durban. South Africa. South African Vitamin A Study Group. AIDS 13:1517–1524

    Article  PubMed  CAS  Google Scholar 

  35. Kumwenda N, Miotti P, Taha T, Broadhead R, Biggar R, Jackson J, Melikian G, Semba R (2002) Antenatal vitamin A supplementation increases birth weight and decreases anemia among infants born to human immunodeficiency virus-infected women in Malawi. Clin Infect Dis 35:618–624

    Article  PubMed  CAS  Google Scholar 

  36. Fawzi W, Msamanga G, Spiegelman D, Urassa E, McGrath N, Mwakagile D, Antelman G, Mbise R, Herrera G, Kapiga S, Willett W, Hunter D (1998) Randomised trial of effects of vitamin supplements on pregnancy outcomes and T cell counts in HIV-1-infected women in Tanzania. Lancet 351:1477–1482

    Article  PubMed  CAS  Google Scholar 

  37. Villamor E, Msamanga G, Spiegelman D, Antelman G, Peterson K, Hunter D, Fawzi W (2002) Effect of multivitamin and vitamin A supplements on weight gain during pregnancy among HIV-1-infected women. Am J Clin Nutr 76:1082–1090

    PubMed  CAS  Google Scholar 

  38. Semba R, Miotti P, Chiphangwi J, Saah A, Canner J, Dallabetta G, Hoover D (1994) Maternal vitamin A deficiency and mother-to-child transmission of HIV-1. Lancet 343:1593–1597

    Article  PubMed  CAS  Google Scholar 

  39. Fawzi W, Msamanga G, Hunter D, Renjifo B, Antelman G, Bang H, Manji K, Kapiga S, Mwakagile D, Essex M, Spiegelman D (2002) Randomized trial of vitamin supplements in relation to transmission of HIV-1 through breastfeeding and early child mortality. AIDS 16:1935–1944

    Article  PubMed  CAS  Google Scholar 

  40. Fawzi W, Msamanga G, Antelman G, Xu C, Hertzmark E, Spiegelman D, Hunter D, Anderson D (2004) Effect of prenatal vitamin supplementation on lower-genital levels of HIV type 1 and interleukin type 1 beta at 36 weeks of gestation. Clin Infect Dis 38:716–722

    Article  PubMed  CAS  Google Scholar 

  41. Humphrey J, Iliff P, Marinda E, Mutasa K, Moulton L, Chidawanyika H, Ward B, Nathoo K, Malaba L, Zijenah L, Zvandasara P, Ntozini R, Mzengeza F, Mahomva A, Ruff A, Mbizvo M, Zunguza C (2006) Effects of a single large dose of vitamin A, given during the postpartum period to HIV-positive women and their infants, on child HIV infection, HIV-free survival, and mortality. J Infect Dis 193:860–871

    Article  PubMed  CAS  Google Scholar 

  42. MacDonald K, Malonza I, Chen D, Nagelkerke N, Nasio J, Ndinya-Achola J, Bwayo J, Sitar D, Aoki F, Plummer F (2001) Vitamin A and risk of HIV-1 seroconversion among Kenyan men with genital ulcers. AIDS 15:635–639

    Article  PubMed  CAS  Google Scholar 

  43. Fawzi W, Hunter D (1998) Vitamins in HIV disease progression and vertical transmission. Epidemiology 9:457–466

    Article  PubMed  CAS  Google Scholar 

  44. Kantarci S, Koulinska I, Aboud S, Fawzi W, Villamor E (2007) Subclinical mastitis, cell-associated HIV-1 shedding in breast milk, and breast-feeding transmission of HIV-1. J Acquir Immune Defic Syndr 46:651–654

    Article  PubMed  Google Scholar 

  45. Baylin A, Villamor E, Rifai N, Msamanga G, Fawzi W (2005) Effect of vitamin supplementation to HIV-infected pregnant women on the micronutrient status of their infants. Eur J Clin Nutr 59:960–968

    Article  PubMed  CAS  Google Scholar 

  46. Webb A, Aboud S, Furtado J, Murrin C, Campos H, Fawzi W, Villamor E (2009) Effect of vitamin supplementation on breast milk concentrations of retinol, carotenoids and tocopherols in HIV-infected Tanzanian women. Eur J Clin Nutr 63:332–339

    Article  PubMed  CAS  Google Scholar 

  47. Fawzi W, Msamanga G, Wei R, Spiegelman D, Antelman G, Villamor E, Manji K, Hunter D (2003) Effect of providing vitamin supplements to human immunodeficiency virus-infected, lactating mothers on the child’s morbidity and CD4+ cell counts. Clin Infect Dis 36:1053–1062

    Article  PubMed  CAS  Google Scholar 

  48. Villamor E, Saathoff E, Bosch R, Hertzmark E, Baylin A, Manji K, Msamanga G, Hunter D, Fawzi W (2005) Vitamin supplementation of HIV-infected women improves postnatal child growth. Am J Clin Nutr 81:880–888

    PubMed  CAS  Google Scholar 

  49. Filteau S, Rollins N, Coutsoudis A, Sullivan K, Willumsen J, Tomkins A (2001) The effect of antenatal vitamin A and beta-carotene supplementation on gut integrity of infants of HIV-infected South African women. J Pediat Gastroenterol Nutr 32:464–470

    Article  CAS  Google Scholar 

  50. Hanekom W, Yogev R, Heald L, Edwards K, Hussey G, Chadwick E (2000) Effect of vitamin A therapy on serologic responses and viral load changes after influenza vaccination in children infected with the human immunodeficiency virus. J Pediatr 136:550–552

    Article  PubMed  CAS  Google Scholar 

  51. Coutsoudis A, Bobat R, Coovadia H, Kuhn L, Tsai W, Stein Z (1995) The effects of vitamin A supplementation on the morbidity of children born to HIV-infected women. Am J Public Health 85:1076–1081

    Article  PubMed  CAS  Google Scholar 

  52. Semba R, Ndugwa C, Perry R, Clark T, Jackson J, Melikian G, Tielsch J, Mmiro F (2005) Effect of periodic vitamin A supplementation on mortality and morbidity of human immunodeficiency virus-infected children in Uganda: a controlled clinical trial. Nutrition 21:25–31

    Article  PubMed  CAS  Google Scholar 

  53. Fawzi W, Mbise R, Hertzmark E, Fataki M, Herrera M, Ndossi G, Spiegelman D (1999) A randomized trial of vitamin A supplements in relation to mortality among human immunodeficiency virus-infected and uninfected children in Tanzania. Pediatr Infect Dis J 18:127–133

    Article  PubMed  CAS  Google Scholar 

  54. Villamor E, Mbise R, Spiegelman D, Hertzmark E, Fataki M, Peterson K, Ndossi G, Fawzi W (2002) Vitamin A supplements ameliorate the adverse effect of HIV-1, malaria, and diarrheal infections on child growth. Pediatrics 109:E6

    Article  PubMed  Google Scholar 

  55. Semba R, Muhilal SA, Natadisastra G, Wirasasmita S, Mele L, Ridwan E, West K, Sommer A (1992) Depressed immune response to tetanus in children with vitamin A deficiency. J Nutr 122:101–107

    PubMed  CAS  Google Scholar 

  56. Coutsoudis A, Kiefpiela P, Coovadia H, Broughton M (1992) Vitamin A supplementation enhances specific IgG antibody levels and total lymphocyte numbers while improving morbidity in measles. Pediatr Infect Dis J 11:203–209

    Article  PubMed  CAS  Google Scholar 

  57. Chandra RK, Wadhwa M (1989) Nutritional modulation of intestinal mucosal immunity. Immunol Invest 18:119–126

    Article  PubMed  CAS  Google Scholar 

  58. Thurnham D, Northrop-Clewes C, McCullough F, Das B, Lunn P (2000) Innate immunity, gut integrity, and vitamin A in Gambian and Indian infants. J Infect Dis 182(Suppl 1):S23–S28

    Article  PubMed  CAS  Google Scholar 

  59. Arpadi S, McMahon D, Abrams E, Bamji M, Purswani M, Engelson E, Morlick M, Shane E (2009) Effect of bimonthly supplementation with oral cholecalciferol on serum 25-hydroxyvitamin D concentrations in HIV-infected children and adolescents. Pediatrics 123:e121–e126

    Article  PubMed  Google Scholar 

  60. Cantorna M, Zhu Y, Froicu M, Wittke A (2004) Vitamin D status, 1, 25-dihydroxyvitamin D3, and the immune system. Am J Clin Nutr 80(6 suppl):1717S–1720S

    PubMed  CAS  Google Scholar 

  61. Villamor E (2006) A potential role for vitamin D on HIV infection? Nutr Rev 64:226–233

    Article  PubMed  Google Scholar 

  62. Toma E, Devost D, Chow LN, Bhat P (2001) HIV-protease inhibitors alter retinoic acid synthesis. AIDS 15:1979–1984

    Article  PubMed  CAS  Google Scholar 

  63. Tang A, Smit E, Semba R, Shah N, Lyles C, Li D, Vlahov D (2000) Improved antioxidant status among HIV-infected injecting drug users on potent antiretroviral therapy. J Acquir Immune Defic Syndr 23:321–326

    PubMed  CAS  Google Scholar 

  64. Remacha A, Cadafalch J, Sarda P, Barcelo M, Fuster M (2003) Vitamin B-12 metabolism in HIV-infected patients in the age of highly active antiretroviral therapy: role of homocysteine in assessing vitamin B-12 status. Am J Clin Nutr 77:420–424

    PubMed  CAS  Google Scholar 

  65. de Souza Júnior O, Treitinger A, Baggio GL, Michelon C, Verdi JC, Cunha J, Ferreira SI, Spada C (2005) Alpha-tocopherol as an antiretroviral therapy supplement for HIV-1-infected patients for increased lymphocyte viability. Clin Chem Lab Med 43:376–382

    PubMed  Google Scholar 

  66. Jaruga P, Jaruga B, Gackowski D, Olczak A, Halota W, Pawlowka M, Olinski R (2002) Supplementation with antioxidant vitamins prevents oxidative modification of DNA in lymphocytes of HIV-infected patients. Free Radic Biol Med 32:414–420

    Article  PubMed  CAS  Google Scholar 

  67. Kaiser J, Campa A, Ondercin J, Leoung G, Pless R, Baum M (2006) Micronutrient supplementation increases CD4 count in HIV-infected individuals on highly active antiretroviral therapy: a prospective, double-blinded, placebo-controlled trial. J Acquir Immune Defic Syndr 42:523–528

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, 02115, MA, USA

    Joanne E. Arsenault PHD, RD & Eduardo Villamor

Authors
  1. Joanne E. Arsenault PHD, RD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eduardo Villamor
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joanne E. Arsenault PHD, RD .

Editor information

Editors and Affiliations

  1. Health Sciences Center, Department of Health Promotion Sciences, University of Arizona, 1295 N. Martin Ave. 1295, Tucson, 85724-5155, USA

    Ronald Ross Watson

  2. Mel & Enid Zuckerman College of, Public Health, University of Arizona, Tucson, 85724-5163, USA

    Sherma Zibadi

  3. Dept. Nutrition & Dietetics, King's College, Stamford St. 150, London, SE1 9NH, United Kingdom

    Victor R. Preedy

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Arsenault, J.E., Villamor, E. (2010). Vitamin Supplements and Disease Resistance in HIV-Infected Women and Children. In: Watson, R., Zibadi, S., Preedy, V. (eds) Dietary Components and Immune Function. Nutrition and Health. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-061-8_15

Download citation

  • DOI: https://doi.org/10.1007/978-1-60761-061-8_15

  • Published:

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-60761-060-1

  • Online ISBN: 978-1-60761-061-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation