Vitamins in HIV disease progression and vertical transmission.
Epidemiology; VOL: 9 (4); p. 457-66
Fawzi WW; Hunter DJ
Human immunodeficiency virus (HIV) infection is a major public health
problem worldwide, but particularly in subsaharan Africa and Asia. Numerous
observational studies report inverse associations between vitamin status,
measured biochemically or as levels of dietary intake, and the risk of
disease progression or vertical transmission. Evidence to support these
findings has been obtained from a few randomized placebo-controlled trials.
In this paper, we review studies that examined the role of vitamins A,
B, C, D, and E in HIV disease progression and transmission, and we discuss
the potential mechanisms of action of these vitamins. Adequate vitamin
intake leads to enhancement of epithelial integrity and systemic immunity
and could contribute to improved clinical condition among HIV-infected
subjects and reduce vertical transmission by reducing the risk and severity
of opportunistic infection and reducing viral load in blood. Adequate
vitamin status may also reduce vertical transmission through the intrapartum
and breastfeeding routes by reducing HIV viral load in lower genital
secretions and breast milk, respectively. Vitamin supplements may be
one of a few potential treatments that are inexpensive enough to be made
available to HIV-infected persons in developing countries.