Coutsoudis A, Bobat R A, Coovadia H M, Kuhn L, Tsai W Y, Stein Z A
Department of Paediatrics and Child Health, University of Natal, Durban, South Africa.
Am J Public Health. 1995 Aug;85(8 Pt 1):1076-81. doi: 10.2105/ajph.85.8_pt_1.1076.
The effects of vitamin A supplementation on morbidity of children born to human immunodeficiency virus (HIV)-infected women were evaluated in a population where vitamin A deficiency is not endemic.
A randomized, placebo-controlled trial of vitamin A supplementation was carried out in 118 offspring of HIV-infected women in Durban, South Africa. Those assigned to receive a supplement were given 50,000 IU of vitamin A at 1 and 3 months of age; 100,000 IU at 6 and 9 months; and 200,000 IU at 12 and 15 months. Morbidity in the past month was then recalled at each follow-up visit. Analysis was based on 806 child-months.
Among all children, the supplemented group had lower overall morbidity than the placebo group (OR = 0.69; 95% confidence interval [CI] = 0.48, 0.99). Among the 85 children of known HIV status (28 infected, 57 uninfected), morbidity associated with diarrhea was significantly reduced in the supplemented infected children (OR = 0.51; 95% CI = 0.27, 0.99), whereas no effect of supplementation on diarrheal morbidity was noted among the uninfected children.
In a population not generally vitamin A deficient, vitamin A supplementation for children of HIV-infected women appeared to be beneficial, reducing morbidity. The benefit was observed particularly for diarrhea among HIV-infected children.
在一个维生素A缺乏并非地方性流行的人群中,评估补充维生素A对感染人类免疫缺陷病毒(HIV)的妇女所生儿童发病率的影响。
在南非德班对118名感染HIV的妇女的后代进行了一项补充维生素A的随机、安慰剂对照试验。分配到接受补充剂的儿童在1个月和3个月大时给予50,000国际单位的维生素A;6个月和9个月时给予100,000国际单位;12个月和15个月时给予200,000国际单位。然后在每次随访时回顾过去一个月的发病率。分析基于806个儿童月。
在所有儿童中,补充组的总体发病率低于安慰剂组(比值比[OR]=0.69;95%置信区间[CI]=0.48,0.99)。在85名已知HIV感染状况的儿童中(28名感染,57名未感染),补充维生素A的感染儿童中与腹泻相关的发病率显著降低(OR=0.51;95%CI=0.27,0.99),而在未感染儿童中未观察到补充剂对腹泻发病率的影响。
在一个总体上不存在维生素A缺乏的人群中,对感染HIV的妇女的儿童补充维生素A似乎有益,可降低发病率。这种益处尤其在感染HIV的儿童的腹泻方面观察到。