Maternal vitamin A deficiency and mother-to-child transmission of HIV-1
Lancet 1994 Jun 25; 343(8913):1593-7
Semba RD; Miotti PG; Chiphangwi JD; Saah AJ; Canner JK; Dallabetta GA; Hoover DR
Studies show that around 10-40% HIV-positive women will give birth to children who are also infected. However, the risk factors for transmission from mother to child are not well understood and the effects of maternal nutritional status are unknown. We conducted a study ofvitaminA status in pregnant women as a risk factor for mother-to-child transmissionof HIV in Malawi. Serum vitaminA, height, weight, CD4 T-cell counts, and duration of breastfeeding were measured in 338 HIV-positive mothers whose infant's HIV serostatus was known. Mother-to-child transmissionof HIV was 21.9% among mothers whose infants survived to 12 months of age. Mean vitaminA concentration in 74 mothers who transmitted HIV to their infants was lower than that in 264 mothers who did not transmit HIV to their infants (0.86 [0.03] vs 1.07 [0.02], p < 0.0001). We divided HIV positive mothers to 4 groups, those with vitaminA concentrations of less than 0.70, between 0.70 and 1.05, between 1.05 and 1.40, and greater than or equal to 1.40 mumol/L. The mother-to-child transmission rates for each group were 32.4%, 26.2%, 16.0%, and 7.2%, respectively (p < 0.0001). Maternal CD4 cell counts, CD4%, and CD4/CD8 ratio were also associated with increased mother-to-child transmissionof HIV. Maternal age, body-mass index, and breastfeeding practices were not significantly associated with higher mother-to-child transmission. Our study suggests that maternal vitaminAdeficiency contributes to mother-to-child transmissionof HIV.