Fawzi Wafaie W, Msamanga Gernard I, Kupka Roland, Spiegelman Donna, Villamor Eduardo, Mugusi Ferdinand, Wei Ruilan, Hunter David
Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.
Am J Clin Nutr. 2007 May;85(5):1335-43. doi: 10.1093/ajcn/85.5.1335.
Anemia is a frequent complication among HIV-infected persons and is associated with faster disease progression and mortality.
We examined the effect of multivitamin supplementation on hemoglobin concentrations and the risk of anemia among HIV-infected pregnant women and their children.
HIV-1-infected pregnant women (n = 1078) from Dar es Salaam, Tanzania, were enrolled in a double-blind trial and provided daily supplements of preformed vitamin A and beta-carotene, multivitamins (vitamins B, C, and E), preformed vitamin A and beta-carotene + multivitamins, or placebo. All women received iron and folate supplements only during pregnancy according to local standard of care. The median follow-up time for hemoglobin measurement for mothers was 57.3 mo [interquartile range (IQR): 28.6-66.8] and for children it was 28.0 mo (IQR: 5.3-41.7).
During the whole period, hemoglobin concentrations among women who received multivitamins were 0.33 g/dL higher than among women who did not receive multivitamins (P=0.07). Compared with placebo, multivitamin supplementation resulted in a hemoglobin increase of 0.59 g/dL during the first 2 y after enrollment (P=0.0002). Compared with placebo, the children born to mothers who received multivitamins had a reduced risk of anemia. In this group, the risk of macrocytic anemia was 63% lower than in the placebo group (relative risk: 0.37: 95% CI: 0.18, 0.79; P=0.01).
Multivitamin supplementation provided during pregnancy and in the postpartum period resulted in significant improvements in hematologic status among HIV-infected women and their children, which provides further support for the value of multivitamin supplementation in HIV-infected adults.
贫血是HIV感染者常见的并发症，与疾病进展加快和死亡率相关。
我们研究了补充多种维生素对感染HIV的孕妇及其子女血红蛋白浓度和贫血风险的影响。
来自坦桑尼亚达累斯萨拉姆的1078名HIV-1感染孕妇参与了一项双盲试验，她们被给予每日补充预先形成的维生素A和β-胡萝卜素、多种维生素（维生素B、C和E）、预先形成的维生素A和β-胡萝卜素+多种维生素或安慰剂。所有女性在孕期仅根据当地护理标准补充铁和叶酸。母亲血红蛋白测量的中位随访时间为57.3个月[四分位间距（IQR）：28.6 - 66.8]，儿童为28.0个月（IQR：5.3 - 41.7）。
在整个期间，接受多种维生素的女性血红蛋白浓度比未接受多种维生素的女性高0.33 g/dL（P = 0.07）。与安慰剂相比，补充多种维生素使入组后头2年血红蛋白增加了0.59 g/dL（P = 0.0002）。与安慰剂相比，接受多种维生素的母亲所生儿童患贫血的风险降低。在该组中，大细胞性贫血的风险比安慰剂组低63%（相对风险：0.37；95%置信区间：0.18，0.79；P = 0.01）。
孕期和产后补充多种维生素可显著改善感染HIV的女性及其子女的血液学状况，这为在感染HIV的成年人中补充多种维生素的价值提供了进一步支持。
