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Breastfeeding HIV-positive women should not receive vitamin A supplements, study shows

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August 30, 2010

HIV-positive women who are breastfeeding should not be given vitamin A supplements because it increases the risk of transmitting the AIDS virus to their infants, researchers said Thursday. Mother-to-child transmission of HIV has been largely controlled in the United States and other developed countries through the use of antiretroviral drugs, but is a major problem in the developing world. In 2008, there were 430,000 new HIV infections in infants, most of them in sub-Saharan Africa, and breast feeding accounted for more than 95% of them. Vitamin A supplements are commonly given to pregnant women in such countries, but physicians generally do not take into account the women's HIV status.

In one study reported in the American Journal of Clinical Nutrition, epidemiologist Eduardo Villamor of the University of Michigan School of Public Health and his colleagues studied 1,078 HIV-positive women who were pregnant. Half received 5,000 international units of vitamin A and 30 milligrams of beta-carotene every day during gestation and lactation and half received a placebo. The combination of supplements increased the risk of passing the virus to the infants, and it appeared that each supplement had an effect individually, Villamor said.

In a second study in the same journal, Villamor and his colleagues found that the supplements increase the risk of subclinical mastitis in HIV-positive women. Subclinical mastitis is an inflammatory condition that causes blood plasma to leak into the mammary gland, carrying virus particles with it.

"The takeaway is that daily supplementation of HIV-infected pregnant or lactating women with vitamin A and beta-carotene at the doses tested is probably not safe and efforts need to be strengthened on preventing mother-to-child transmission through other interventions, such as antiretroviral agents," Villamor said in a statement.

-- Thomas H. Maugh II / Los Angeles Times

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