Following the finding that mothers with low serum levels of
vitamin A were more likely to transmit HIV to their children195,
supplementation of vitamin A has been suggested as a preventive treatment.
Several randomized controlled trials of vitamin A and other micronutrients are
in progress (Table 3). The potential advantages of micronutrient supplementation
would be the low price, possible other nutritional and health benefits for the
mother and the fact that the intervention could be implemented simply without
the need for HIV testing. Vitamin A deficiency has also been associated with
increased viral loads in breast milk, and any reduction following
supplementation would also be of benefit in breastfeeding women159.
Other micronutrients such as Zinc and Selenium have also been suggested as
possible preventive agents.
A randomized controlled trial in the United Republic of Tanzania
showed that multivitamin supplementation in HIV positive pregnant women
decreased the risk of low birth weight by 44%, severe preterm birth (under 34
weeks gestation) by 39% and small size for gestational age at birth by 43%.
Vitamin A supplementation had no effect on these variables. The multivitamin
supplementation, but not vitamin A, resulted in significant increases in CD4+,
CD8 and CD3 counts. The effect on mother-to-child transmission in this study has
yet to be determined295. Preliminary reports from other vitamin A
intervention trials suggest little benefit on transmission from vitamin A