OBJECTIVE: To test whether post-partum vitamin A supplementation can reduce incident HIV among post-partum women and identify risk factors for HIV incidence. DESIGN: Randomized, placebo-controlled trial METHODS:Between November 1997 and January 2001, 14,110 women were randomly administered 400,000 IU vitamin A or placebo within 96 h post-partum. HIV incidence was monitored among 9562 HIV-negative women. RESULTS:Cumulative incidence was 3.4% [95% confidence interval (CI), 3.0-3.8] and 6.5% (95% CI, 5.7-7.4) over 12 and 24 months post-partum, respectively. Vitamin A supplementation had no impact on incidence [hazard ratio (HR), 1.08; 95% CI, 0.85-1.38]. However, among 398 women for whombaseline serum retinol was measured, those with levels indicative of deficiency (< 0.7 micromol/l, 9.2% of those measured) were 10.4 (95% CI, 3.0-36.3) times more likely to seroconvert than women with higher concentrations. Furthermore, among women with low serum retinol, vitamin A supplementation tended to be protective against incidence (HR, 0.29; 95% CI, 0.03-2.60; P = 0.26), although not significantly so, perhaps due to limited statistical power. Severe anaemia (haemoglobin < 70 g/l) was associated with a 2.7-fold (95%CI, 1.2-6.1) greater incidence. Younger women were at higher risk of HIV infection: incidence declined by 5.7% (2.8-8.6) with each additional year of age. CONCLUSION: Among post-partum women, a single large-dose vitamin A supplementation had no effect on incidence, although low serum retinol was a risk factor for seroconversion. Further investigation is required to determine whether vitamin A supplementation of vitamin-A-deficient women or treatment of anaemic women can reduce HIV incidence.
RCT Entities:
OBJECTIVE: To test whether post-partum vitamin A supplementation can reduce incident HIV among post-partum women and identify risk factors for HIV incidence. DESIGN: Randomized, placebo-controlled trial METHODS: Between November 1997 and January 2001, 14,110 women were randomly administered 400,000 IU vitamin A or placebo within 96 h post-partum. HIV incidence was monitored among 9562 HIV-negative women. RESULTS: Cumulative incidence was 3.4% [95% confidence interval (CI), 3.0-3.8] and 6.5% (95% CI, 5.7-7.4) over 12 and 24 months post-partum, respectively. Vitamin A supplementation had no impact on incidence [hazard ratio (HR), 1.08; 95% CI, 0.85-1.38]. However, among 398 women for whom baseline serum retinol was measured, those with levels indicative of deficiency (< 0.7 micromol/l, 9.2% of those measured) were 10.4 (95% CI, 3.0-36.3) times more likely to seroconvert than women with higher concentrations. Furthermore, among women with low serum retinol, vitamin A supplementation tended to be protective against incidence (HR, 0.29; 95% CI, 0.03-2.60; P = 0.26), although not significantly so, perhaps due to limited statistical power. Severe anaemia (haemoglobin < 70 g/l) was associated with a 2.7-fold (95%CI, 1.2-6.1) greater incidence. Younger women were at higher risk of HIV infection: incidence declined by 5.7% (2.8-8.6) with each additional year of age. CONCLUSION: Among post-partum women, a single large-dose vitamin A supplementation had no effect on incidence, although low serum retinol was a risk factor for seroconversion. Further investigation is required to determine whether vitamin A supplementation of vitamin-A-deficient women or treatment of anaemic women can reduce HIV incidence.
Authors: J H Humphrey; K J Nathoo; J W Hargrove; P J Iliff; K E Mutasa; L H Moulton; H Chidawanyika; L C Malaba; L S Zijenah; P Zvandasara; R Ntozini; C D Zunguza; B J Ward Journal: Epidemiol Infect Date: 2007-01-12 Impact factor: 2.451
Authors: Jillian Pintye; Alison L Drake; John Kinuthia; Jennifer A Unger; Daniel Matemo; Renee A Heffron; Ruanne V Barnabas; Pamela Kohler; R Scott McClelland; Grace John-Stewart Journal: Clin Infect Dis Date: 2017-03-15 Impact factor: 9.079
Authors: Simon Gregson; Elizabeth Gonese; Timothy B Hallett; Noah Taruberekera; John W Hargrove; Ben Lopman; Elizabeth L Corbett; Rob Dorrington; Sabada Dube; Karl Dehne; Owen Mugurungi Journal: Int J Epidemiol Date: 2010-04-20 Impact factor: 7.196
Authors: Joanne Katz; Anne Cc Lee; Naoko Kozuki; Joy E Lawn; Simon Cousens; Hannah Blencowe; Majid Ezzati; Zulfiqar A Bhutta; Tanya Marchant; Barbara A Willey; Linda Adair; Fernando Barros; Abdullah H Baqui; Parul Christian; Wafaie Fawzi; Rogelio Gonzalez; Jean Humphrey; Lieven Huybregts; Patrick Kolsteren; Aroonsri Mongkolchati; Luke C Mullany; Richard Ndyomugyenyi; Jyh Kae Nien; David Osrin; Dominique Roberfroid; Ayesha Sania; Christentze Schmiegelow; Mariangela F Silveira; James Tielsch; Anjana Vaidya; Sithembiso C Velaphi; Cesar G Victora; Deborah Watson-Jones; Robert E Black Journal: Lancet Date: 2013-06-06 Impact factor: 79.321