INFANT HIV INFECTION MAY BE CONNECTED TO VITAMIN A
By Christine A. Rowett

Pregnant women with the HIV virus may have the ability to
decrease the chances of transmitting the infection to their
unborn children.
    School of Public Health researchers have found that
HIV-infected mothers who are deficient in vitamin A during
pregnancy are three to four times more likely to pass the HIV
infection to their child. Vitamin A is essential to the
immune system.
    "Our study raises the possibility that improving the
mother's nutrition through vitamin supplementation during
pregnancy may be a potential strategy to decrease the chance
of her having an HIV-infected child," said Richard Semba,
lead author of the study. Dr. Semba is an assistant professor
with the Center for Human Nutrition, Department of
International Health.
    The researchers' findings were published in the June 25
issue of The Lancet.
    Dr. Semba said the study of nutrition and infectious
diseases should be more closely examined. "The area of
nutrition and HIV infection has been somewhat neglected," he
said. "It seems that we have ignored some basic things."
    As part of the four-year study, which was conducted in
Malawi, Africa, researchers examined the vitamin A levels of
338 HIV-infected women during their pregnancies. The infants
were studied from birth to age 1.
    The vitamin A-deficient mothers had a significantly
higher transmission rate. Thirty-two percent of mothers low
in vitamin A transmitted the virus to their children; only 7
percent of babies born to mothers with healthy levels of the
vitamin were born with the virus.
    "Vitamin A deficiency may explain why some HIV-infected
mothers have HIV-infected infants and others do not," Dr.
Semba said. "This may be due to the important role that
vitamin A plays in stimulating the immune system."
    Currently, about 10 to 40 percent of infants born to
HIV-infected mothers are born with the virus worldwide. The
figure for infants in the United States is approximately 10
to 15 percent.
    There are three ways an HIV-infected mother can transmit
the virus, Dr. Semba said: during pregnancy, during delivery
and through breast-feeding.
    In developing parts of the world, many HIV-infected
mothers are unaware they have the virus, and the benefits of
breast-feeding far outweigh the risks of bottle-feeding, he
said.
    "Breast-feeding is how infants get most of their
nutrients," Dr. Semba said, "and it would be a disaster to
advocate that women stop breast-feeding." Caesarean sections
to reduce infant exposure to HIV-infected blood are not a
viable option in developing countries.
    The pregnant women in the study who had deficient
vitamin A levels had about one-half the amount of vitamin A
as women with sufficient levels, he said.
    "We found that vitamin A deficiency was common in
HIV-infected women, and, the worse the deficiency, the higher
the HIV transmission rate," he said.
    Pregnant mothers can increase their vitamin A levels by
increasing their intake of liver, spinach, carrots or
prenatal vitamin supplements.
    Dr. Semba said he has been studying vitamin A for about
seven years, initially doing research with School of Public
Health Dean Alfred Sommer, who determined that regular
vitamin A supplementation could reduce child mortality by
about one-third in developing countries.
    "When we confirmed that vitamin A was also making the
immune system stronger, it was quite natural to turn to HIV
and AIDS," Dr. Semba said.
    He stressed, however, that there is no concrete proof
that vitamin A will affect the progress of HIV infection or
AIDS.
    "I would caution against people taking mega-doses of
vitamins because they think it might help them," he said.
"Until studies are done that can establish what is
beneficial, it is not a good idea to take too much of any
vitamin."
    There is currently an "urgent search" for prevention
methods to avoid HIV-infected newborns, he said. "Worldwide,
the number of HIV-infected children is growing into the
millions," he said.
    The research team will further examine their findings
through upcoming clinical trials in sub-Saharan Africa as
soon as next year, Dr. Semba said.
    He said he hopes those studies will determine whether a
prenatal supplement including vitamin A would increase the
chance for healthy births.
    The vitamin A/HIV study was supported by the National
Institutes of Health and the United States Agency for
International Development.