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Randomised trial of effects of vitamin supplements on pregnancy outcomes and T cell counts in HIV-1-infected women in Tanzania
In HIV-1-infected women, poor micronutrient status has been associated with faster progression of HIV-1 disease and adverse birth outcomes. We assessed the effects of vitamin A and multivitamins on birth outcomes in such women. In Tanzania, 1075 HIV-1-infected pregnant women at between 12 and 27 wee...
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| Published in: | The Lancet (British edition) 1998-05, Vol.351 (9114), p.1477-1482 |
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| Main Authors: | , , , , , , , , , , , |
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| cites | cdi_FETCH-LOGICAL-c497t-1242642692d4b596b7dcce81ec73e395ac95b1c7ece491b5fb49b164be8dafc03 |
| container_end_page | 1482 |
| container_issue | 9114 |
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| container_title | The Lancet (British edition) |
| container_volume | 351 |
| creator | Fawzi, Wafaie W Msamanga, Gernard I Spiegelman, Donna Urassa, Ernest JN McGrath, Nuala Mwakagile, Davis Antelman, Gretchen Mbise, Roger Kapiga, Saidi Willett, Walter Hunter, David J Herrera, Guillermo |
| description | In HIV-1-infected women, poor micronutrient status has been associated with faster progression of HIV-1 disease and adverse birth outcomes. We assessed the effects of vitamin A and multivitamins on birth outcomes in such women.
In Tanzania, 1075 HIV-1-infected pregnant women at between 12 and 27 weeks' gestation received placebo (n=267), vitamin A (n=269), multivitamins excluding vitamin A (n=269), or multivitamins including vitamin A (n=270) in a randomised, double-blind, placebo-controlled trial with a 2×2 factorial design. We measured the effects of multivitamins and vitamin A on birth outcomes and counts of T lymphocyte subsets. We did analyses by intention to treat.
30 fetal deaths occurred among women assigned multivitamins compared with 49 among those not on multivitamins (relative risk 0·61 [95% CI 0·39–0·94] p=0·02). Multivitamin supplementation decreased the risk of low birthweight ( |
| doi_str_mv | 10.1016/S0140-6736(98)04197-X |
| format | article |
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In Tanzania, 1075 HIV-1-infected pregnant women at between 12 and 27 weeks' gestation received placebo (n=267), vitamin A (n=269), multivitamins excluding vitamin A (n=269), or multivitamins including vitamin A (n=270) in a randomised, double-blind, placebo-controlled trial with a 2×2 factorial design. We measured the effects of multivitamins and vitamin A on birth outcomes and counts of T lymphocyte subsets. We did analyses by intention to treat.
30 fetal deaths occurred among women assigned multivitamins compared with 49 among those not on multivitamins (relative risk 0·61 [95% CI 0·39–0·94] p=0·02). Multivitamin supplementation decreased the risk of low birthweight (<2500 g) by 44% (0·56 [0·38–0·82] p=0·003), severe preterm birth (<34 weeks of gestation) by 39% (0·61 [0·38–0·96] p=0·03), and small size for gestational age at birth by 43% (0·57 [0·39–0·82] p=0·002). Vitamin A supplementation had no significant effect on these variables. Multivitamins, but not vitamin A, resulted in a significant increase in CD4, CD8, and CD3 counts.
Multivitamin supplementation is a low-cost way of substantially decreasing adverse pregnancy outcomes and increasing T-cell counts in HIV-1-infected women. The clinical relevance of our findings for vertical transmission and clinical progression of HIV-1 disease is yet to be ascertained.</description><identifier>ISSN: 0140-6736</identifier><identifier>EISSN: 1474-547X</identifier><identifier>DOI: 10.1016/S0140-6736(98)04197-X</identifier><identifier>PMID: 9605804</identifier><identifier>CODEN: LANCAO</identifier><language>eng</language><publisher>London: Elsevier Ltd</publisher><subject>AIDS/HIV ; Biological and medical sciences ; CD3 Complex ; CD4 Lymphocyte Count ; CD8-Positive T-Lymphocytes ; Clinical trials ; Developing Countries ; Disease Progression ; Double-Blind Method ; Female ; HIV ; HIV Infections - drug therapy ; HIV Infections - epidemiology ; HIV Infections - immunology ; HIV-1 ; Human immunodeficiency virus ; Humans ; Infant, Newborn ; Lymphocyte Count ; Lymphocytes ; Medical sciences ; Miscellaneous ; Pharmacology. Drug treatments ; Population ; Pregnancy ; Pregnancy Complications, Infectious - drug therapy ; Pregnancy Complications, Infectious - epidemiology ; Pregnancy Complications, Infectious - immunology ; Pregnancy Outcome ; Tanzania - epidemiology ; Tropical medicine ; Vitamin A - administration & dosage ; Vitamin A - therapeutic use ; Vitamins ; Vitamins - administration & dosage ; Vitamins - therapeutic use ; Women</subject><ispartof>The Lancet (British edition), 1998-05, Vol.351 (9114), p.1477-1482</ispartof><rights>1998 Elsevier Ltd</rights><rights>1998 INIST-CNRS</rights><rights>Copyright Lancet Ltd. May 16, 1998</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c497t-1242642692d4b596b7dcce81ec73e395ac95b1c7ece491b5fb49b164be8dafc03</citedby><cites>FETCH-LOGICAL-c497t-1242642692d4b596b7dcce81ec73e395ac95b1c7ece491b5fb49b164be8dafc03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2230648$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9605804$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fawzi, Wafaie W</creatorcontrib><creatorcontrib>Msamanga, Gernard I</creatorcontrib><creatorcontrib>Spiegelman, Donna</creatorcontrib><creatorcontrib>Urassa, Ernest JN</creatorcontrib><creatorcontrib>McGrath, Nuala</creatorcontrib><creatorcontrib>Mwakagile, Davis</creatorcontrib><creatorcontrib>Antelman, Gretchen</creatorcontrib><creatorcontrib>Mbise, Roger</creatorcontrib><creatorcontrib>Kapiga, Saidi</creatorcontrib><creatorcontrib>Willett, Walter</creatorcontrib><creatorcontrib>Hunter, David J</creatorcontrib><creatorcontrib>Herrera, Guillermo</creatorcontrib><creatorcontrib>for the Tanzania Vitamin and HIV Infection Trial Team</creatorcontrib><title>Randomised trial of effects of vitamin supplements on pregnancy outcomes and T cell counts in HIV-1-infected women in Tanzania</title><title>The Lancet (British edition)</title><addtitle>Lancet</addtitle><description>In HIV-1-infected women, poor micronutrient status has been associated with faster progression of HIV-1 disease and adverse birth outcomes. We assessed the effects of vitamin A and multivitamins on birth outcomes in such women.
In Tanzania, 1075 HIV-1-infected pregnant women at between 12 and 27 weeks' gestation received placebo (n=267), vitamin A (n=269), multivitamins excluding vitamin A (n=269), or multivitamins including vitamin A (n=270) in a randomised, double-blind, placebo-controlled trial with a 2×2 factorial design. We measured the effects of multivitamins and vitamin A on birth outcomes and counts of T lymphocyte subsets. We did analyses by intention to treat.
30 fetal deaths occurred among women assigned multivitamins compared with 49 among those not on multivitamins (relative risk 0·61 [95% CI 0·39–0·94] p=0·02). Multivitamin supplementation decreased the risk of low birthweight (<2500 g) by 44% (0·56 [0·38–0·82] p=0·003), severe preterm birth (<34 weeks of gestation) by 39% (0·61 [0·38–0·96] p=0·03), and small size for gestational age at birth by 43% (0·57 [0·39–0·82] p=0·002). Vitamin A supplementation had no significant effect on these variables. Multivitamins, but not vitamin A, resulted in a significant increase in CD4, CD8, and CD3 counts.
Multivitamin supplementation is a low-cost way of substantially decreasing adverse pregnancy outcomes and increasing T-cell counts in HIV-1-infected women. 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David J</au><au>Herrera, Guillermo</au><aucorp>for the Tanzania Vitamin and HIV Infection Trial Team</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Randomised trial of effects of vitamin supplements on pregnancy outcomes and T cell counts in HIV-1-infected women in Tanzania</atitle><jtitle>The Lancet (British edition)</jtitle><addtitle>Lancet</addtitle><date>1998-05-16</date><risdate>1998</risdate><volume>351</volume><issue>9114</issue><spage>1477</spage><epage>1482</epage><pages>1477-1482</pages><issn>0140-6736</issn><eissn>1474-547X</eissn><coden>LANCAO</coden><abstract>In HIV-1-infected women, poor micronutrient status has been associated with faster progression of HIV-1 disease and adverse birth outcomes. We assessed the effects of vitamin A and multivitamins on birth outcomes in such women.
In Tanzania, 1075 HIV-1-infected pregnant women at between 12 and 27 weeks' gestation received placebo (n=267), vitamin A (n=269), multivitamins excluding vitamin A (n=269), or multivitamins including vitamin A (n=270) in a randomised, double-blind, placebo-controlled trial with a 2×2 factorial design. We measured the effects of multivitamins and vitamin A on birth outcomes and counts of T lymphocyte subsets. We did analyses by intention to treat.
30 fetal deaths occurred among women assigned multivitamins compared with 49 among those not on multivitamins (relative risk 0·61 [95% CI 0·39–0·94] p=0·02). Multivitamin supplementation decreased the risk of low birthweight (<2500 g) by 44% (0·56 [0·38–0·82] p=0·003), severe preterm birth (<34 weeks of gestation) by 39% (0·61 [0·38–0·96] p=0·03), and small size for gestational age at birth by 43% (0·57 [0·39–0·82] p=0·002). Vitamin A supplementation had no significant effect on these variables. Multivitamins, but not vitamin A, resulted in a significant increase in CD4, CD8, and CD3 counts.
Multivitamin supplementation is a low-cost way of substantially decreasing adverse pregnancy outcomes and increasing T-cell counts in HIV-1-infected women. The clinical relevance of our findings for vertical transmission and clinical progression of HIV-1 disease is yet to be ascertained.</abstract><cop>London</cop><pub>Elsevier Ltd</pub><pmid>9605804</pmid><doi>10.1016/S0140-6736(98)04197-X</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0140-6736 |
| ispartof | The Lancet (British edition), 1998-05, Vol.351 (9114), p.1477-1482 |
| issn | 0140-6736 1474-547X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_79896462 |
| source | Business Source Ultimate; ScienceDirect Journals |
| subjects | AIDS/HIV Biological and medical sciences CD3 Complex CD4 Lymphocyte Count CD8-Positive T-Lymphocytes Clinical trials Developing Countries Disease Progression Double-Blind Method Female HIV HIV Infections - drug therapy HIV Infections - epidemiology HIV Infections - immunology HIV-1 Human immunodeficiency virus Humans Infant, Newborn Lymphocyte Count Lymphocytes Medical sciences Miscellaneous Pharmacology. Drug treatments Population Pregnancy Pregnancy Complications, Infectious - drug therapy Pregnancy Complications, Infectious - epidemiology Pregnancy Complications, Infectious - immunology Pregnancy Outcome Tanzania - epidemiology Tropical medicine Vitamin A - administration & dosage Vitamin A - therapeutic use Vitamins Vitamins - administration & dosage Vitamins - therapeutic use Women |
| title | Randomised trial of effects of vitamin supplements on pregnancy outcomes and T cell counts in HIV-1-infected women in Tanzania |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-30T23%3A16%3A06IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Randomised%20trial%20of%20effects%20of%20vitamin%20supplements%20on%20pregnancy%20outcomes%20and%20T%20cell%20counts%20in%20HIV-1-infected%20women%20in%20Tanzania&rft.jtitle=The%20Lancet%20(British%20edition)&rft.au=Fawzi,%20Wafaie%20W&rft.aucorp=for%20the%20Tanzania%20Vitamin%20and%20HIV%20Infection%20Trial%20Team&rft.date=1998-05-16&rft.volume=351&rft.issue=9114&rft.spage=1477&rft.epage=1482&rft.pages=1477-1482&rft.issn=0140-6736&rft.eissn=1474-547X&rft.coden=LANCAO&rft_id=info:doi/10.1016/S0140-6736(98)04197-X&rft_dat=%3Cproquest_cross%3E79896462%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c497t-1242642692d4b596b7dcce81ec73e395ac95b1c7ece491b5fb49b164be8dafc03%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=199002516&rft_id=info:pmid/9605804&rfr_iscdi=true |