| ||||||
 |  |
|  | | | |
| Farber | The question should not be, Is nevirapine better than AZT? but, Is nevirapine better than nothing? Independent evidence suggests that it is not. A 1994 study, for example, that gave vitamin A to pregnant HIVpositive mothers in Malawi reported that those with the highest levels of Vitamin A transmitted HIV at a rate of only 7.2 percent. This is consistent with a vast body of research linking nutritional status to sero-conversion, as well as to general health. |
| Gallo | Farber's reference to women with higher levels of vitamin A having lower HIV transmission rates implies that HIV MTCT transmission can be resolved with vitamin A supplementation. See above for evidence that vitamin A supplementation is not effective at reducing MTCT. Farber fails to consider that the general ill-health caused by advanced HIV disease is likely to reduce vitamin levels in the body. |
| RA | A 1994 study, probably the one that Farber was referring to, states that “Our study shows that vitamin A deficiency is common among pregnant women who are infected with HIV in Africa and that deficiency is strongly associated with increased mother-to-child transmission of HIV…Vitamin A deficiency was associated with a 3-to-4-fold increased risk of mother-to-child transmission of HIV.” [1] This implies that having some of the children enrolled in a Vitamin A study could have been a confounding variable, especially without a placebo control, as the transmission rate would have to be compared to historical data of mothers and infants who were not exposed to antiretroviral drugs or vitamin supplements. |
| Refs. |
|