MATERNAL VITAMIN-A-DEFICIENCY AND MOTHER-TO-CHILD TRANSMISSION OF HIV-1

Studies show that around 10-40% HIV-positive women will give birth to children who are also infected. However, the risk factors for transmis sion from mother to child are not well understood and the effects of m aternal nutritional status are unknown. We conducted a study of vitami n A status in pregnant women as a risk factor for mother-to-child tran smission of HIV in Malawi. Serum vitamin A, height, weight, CD4 T-cell counts, and duration of breastfeeding were measured in 338 HIV-positi ve mothers whose infant's HIV serostatus was known. Mother-to-child tr ansmission of HIV was 21.9% among mothers whose infants survived to 12 months of age. Mean vitamin A concentration in 74 mothers who transmi tted HIV to their infants was lower than that in 264 mothers who did n ot transmit HIV to their infants (0.86 [0.03] vs 1.07 [0.02], p<0.0001 ). We divided HIV positive mothers to 4 groups, those with vitamin A c oncentrations of less than 0.70, between 0.70 and 1.05, between 1.05 a nd 1.40, and greater than or equal to 1.40 mu mol/L. The mother-to-chi ld transmission rates for each group were 32.4%, 26.2%, 16.0%, and 7.2 %, respectively (p<0.0001). Maternal CD4 cell counts, CD4%, and CD4/CD 8 ratio were also associated with increased mother-to-child transmissi on of HIV. Maternal age, body-mass index, and breastfeeding practices were not significantly associated with higher mother-to-child transmis sion. Our study suggests that maternal vitamin A deficiency contribute s to mother-to-child transmission of HIV.