Lipid-soluble vitamins A, D, and e in HIV-infected pregnant women in Tanzania

Abstract

Background/Objectives: There is limited published research examining lipid-soluble vitamins in human immunodeficiency virus (HIV)-infected pregnant women, particularly in resource-limited settings. Subjects/Methods: This is an observational analysis of 1078 HIV-infected pregnant women enrolled in a trial of vitamin supplementation in Tanzania. Baseline data on sociodemographic and anthropometric characteristics, clinical signs and symptoms, and laboratory parameters were used to identify correlates of low plasma vitamin A (0.7 mol/l), vitamin D (80 nmol/l) and vitamin E (9.7 mol/l) status. Binomial regression was used to estimate risk ratios and 95% confidence intervals. Results: Approximately 35, 39 and 51% of the women had low levels of vitamins A, D and E, respectively. Severe anemia (hemoglobin 85 g/l; P0.01), plasma vitamin E (P0.02), selenium (P0.01) and vitamin D (P0.02) concentrations were significant correlates of low vitamin A status in multivariate models. Erythrocyte Sedimentation Rate (ESR) was independently related to low vitamin A status in a nonlinear manner (P0.01). The correlates of low vitamin D status were CD8 cell count (P0.01), high ESR (ESR 81 mm/h; P0.01), gestational age at enrollment (nonlinear; P0.03) and plasma vitamins A (P0.02) and E (P0.01). For low vitamin E status, the correlates were money spent on food per household per day (P0.01), plasma vitamin A concentration (nonlinear; P0.01) and a gestational age 16 weeks at enrollment (P0.01). Conclusions: Low concentrations of lipid-soluble vitamins are widely prevalent among HIV-infected women in Tanzania and are correlated with other nutritional insufficiencies. Identifying HIV-infected persons at greater risk of poor nutritional status and infections may help inform design and implementation of appropriate interventions. © 2010 Macmillan Publishers Limited All rights reserved.