Herbs, supplements and HIV

January 2005     View PDF     En español

Vitamin supplements and HIV in women
(implications for everyone)

Vitamin deficiencies have been seen in people even at early stages of HIV infection. This has led to an interest in using multivitamins, particularly in resource-poor settings and those where malnutrition is a problem. A study in Tanzania, Africa among HIV-positive pregnant women showed that using multivitamins led to fewer deaths of unborn children, increased birth weights and fewer pre-term births.

However, trends were noted that children born to HIV-positive mothers who took multivitamins during pregnancy were more likely to be infected with HIV. Because of this, another study was started in Kenya to examine the impact of using daily multivitamins (or placebo) and evaluate its impact on vaginal and cervical presence of HIV.

The use of multivitamins was associated with slightly higher CD4+ and CD8+ cell counts and no overall changes in HIV levels in the blood. However, it was also associated with increased vaginal presence of HIV, with about ½ log higher levels of HIV in vaginal swabs. The percentage of vaginal cells with HIV was higher among those taking daily multivitamins (31%) than those on placebo (17%). The differences were less striking in cervical cells.

Researchers speculate that using daily multivitamins among women is unlikely to protect them from HIV disease progression and may increase the chances of passing HIV onto others. The results are perhaps more relevant to places where anti-HIV therapies are not available or to those who choose not to use them together with multivitamins. The use of multivitamins was linked to improved markers of immune health (slight increases in both CD4+ and CD8+ cell counts). It remains unknown whether the increased vaginal presence of HIV from using multivitamins would be controlled while using anti-HIV therapy. (The women in this study were not on anti-HIV therapy.)

Another Kenyan study found that vitamin A deficiencies in blood were associated with increased vaginal presence of HIV during pregnancy, increased HIV in breast milk, higher rates of mother-to-child HIV transmission, lower CD4+ cell counts and more rapid disease progression. Four hundred women took either placebo or vitamin A at the dose recommended by the World Health Organization for correcting symptomatic vitamin A deficiencies in women of child-bearing potential. The study found that the supplements had no effect whatsoever on vaginal presence of HIV, blood levels of HIV, or CD4+ or CD8+ cell counts.

These findings held true even among the 59% of women with notable vitamin A deficiencies at the start of the study. They suggest that while vitamin A deficiencies may be associated with poorer outcomes in passing HIV from mother to child and of HIV disease in general, supplements are unlikely to address these problems. As with the other study, this study did not evaluate using supplements together with anti-HIV therapy.