Item #25: HIVNET 012 Participants Also in a Vitamin A Trial

Westat also discovered that half the HIV-positive infants were also enrolled in a vitamin A trial, which effectively invalidates any data associated with them.

Farber states that the fact that some of the HIVNET 012 participants were on a vitamin A trial negates data associated with them.

If vitamin A supplements were actually effective at reducing MTCT, Farber's statement would be true. However several studies of whether vitamin A supplements reduces MTCT have been conducted. They all found that vitamin A supplementation does not differ from placebo. See the Cochrane review (2006)52 on this. It is possible that vitamin A supplementation confers other benefits, but even this is unclear as a recent Zimbabwean study demonstrates53 .

Vitamin A might not reduce the risk of HIV transmission, in fact it has been shown in some studies [1] to increase the risk of HIV transmission. Studies have also shown that vitamins during pregnancy can improve some health indicators [2] and can reduce progression to AIDS in African mothers [3]. Vitamin A is obviously an important confouding factor, and mothers who had participated in this trial should have been excluded.

1. Fawzi WW et al. Randomized trial of vitamin supplements in relation to transmission of HIV-1 through breastfeeding and early child mortality. AIDS. 2002 Sep 27; 16(14): 1935-1944.
2. Fawzi WW et al. Effect of providing vitamin supplements to human immunodeficiency virus-infected, lactating mothers on the child's morbidity and CD4+ cell counts. Clin Infect Dis. 2003 Apr 15; 36(8): 1053-62.
3. Fawzi WW et al. A Randomized Trial of Multivitamin Supplements and HIV Disease Progression and Mortality. N Engl J Med. 2004 Jul 1; 351(1): 23-32.