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Symposium: Women's Voices, Women's Choices: The Challenge of Nutrition and HIV/AIDS

Studies of Vitamins and Minerals and HIV Transmission and Disease Progression^1,2

Wafaie Fawzi^*,,3, Gernard Msamanga, Donna Spiegelman^,** and David J. Hunter^*,

Departments of ^* Nutrition, Epidemiology, and ^** Biostatistics, Harvard School of Public Health, Boston, MA, and Department of Community Health, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania

³To whom correspondence should be addressed. E-mail: mina{at}hsph.harvard.edu.

HIV-1 infection is having a devastating impact on people in developing countries. Poor nutrition and HIV-related adverse health outcomes contribute to a vicious cycle that may be slowed down by using nutritional interventions, including vitamins and minerals. Among children, periodic supplementation with vitamin A starting at 6 mo of age has been shown to be beneficial in reducing mortality and morbidity among both HIV-infected and uninfected children. Limited data exist on the role of other nutrient supplements among children. Among HIV-infected adults, the safety and the efficacy of vitamin A supplements need further study, although adequate dietary intake of this essential nutrient is recommended. Multivitamin supplements were efficacious in reducing adverse pregnancy outcomes and early childhood infections, and is currently provided to pregnant HIV-infected pregnant women in many programs. The efficacy of such supplements among HIV-negative pregnant women needs further study. Daily multivitamin supplements were found to reduce HIV disease progression among men and women in several observational studies and randomized trials, and to provide an important low-cost intervention that could be provided to adults in early stages of HIV disease to prolong the time before antiretroviral therapy is recommended. Next, research priorities include examining the roles of minerals, including selenium, in HIV infection, as well as determining the safety and the efficacy of micronutrient supplements among individuals who are advanced in their disease and who are receiving antiretroviral therapy.

KEY WORDS: • HIV infection • vitamins • zinc • selenium • mortality

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