Journal of Tropical Pediatrics Advance Access published online on June 5, 2009
Journal of Tropical Pediatrics, doi:10.1093/tropej/fmp045
Vitamin A and Vitamin B-12 Concentrations in Relation to Mortality and Morbidity among Children Born to HIV-Infected Women
a Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
b Department of Pediatrics and Child Health, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania, USA
c Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA
d Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
e Department of Community Health Sciences, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania, USA
f Programme Division, United Nations Children's Fund (UNICEF), New York, USA
Correspondence: Anirban Chatterjee, MD, DSc, c/o Wafaie Fawzi, Department of Nutrition, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA. E-mail: <achatterjee24{at}post.harvard.edu>.
| Abstract |
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Vitamin A supplementation starting at 6 months of age is an important child survival intervention; however, not much is known about the association between vitamin A status before 6 months and mortality among children born to HIV-infected women. Plasma concentrations of vitamins A and B-12 were available at 6 weeks of age (n = 576 and 529, respectively) for children born to HIV-infected women and they were followed up for morbidity and survival status until 24 months after birth. Children in the highest quartile of vitamin A had a 49% lower risk of death by 24 months of age compared to the lowest quartile (HR: 0.51, 95% CI: 0.29–0.90; P-value for trend = 0.01). Higher vitamin A levels were protective in the sub-groups of HIV-infected and un-infected children but this was statistically significant only in the HIV-uninfected subgroup. Higher vitamin A concentrations in plasma are protective against mortality in children born to HIV-infected women.