Serum vitamin A concentrations in a North American cohort of human immunodeficiency virus type 1-infected children

Background. Vitamin A deficiency is associated with increased risks of vert ical transmission of HIV-1 (HIV) and of disease progression and mortality a mong HIV-infected adults. The objectives of the study were to describe seru m vitamin A concentrations among HIV-infected children in the National Inst itute of Child Health and Human Development IVIG; Clinical Trial, to examin e changes in vitamin A concentrations and to investigate the relationships between vitamin A concentrations and morbidity and mortality. methods. Blood was collected from children at baseline and at 3-month inter vals throughout the study. Serum samples were stored at -70 degrees C at a central repository until retrieved for vitamin A assay. Samples were hexane -extracted and assayed by high performance liquid chromatography, The rate of change in vitamin A concentrations, calculated by fitting a linear regre ssion model, was expressed as micrograms/dl/year. Results, The median vitamin A concentration at baseline (n = 207 children) was 31.0 mu g/dl [range, undetectable (<10 mu g/dl) to 98 mu g/dl]. The rat e of change in vitamin A concentrations (n 180 children) did not vary signi ficantly by any factor other than baseline vitamin A concentration. Baselin e vitamin A concentration was not associated with morbidity (incidence of i nfections, growth failure, CD4(+) percent decline below 15%, increases in s erum HIV RNA concentrations above either 10(5) or 10(6) copies/ml or acute care hospitalization). Neither baseline vitamin A concentration nor the rat e of change of vitamin A concentrations was associated with mortality. Conclusions, Among these North American children with relatively normal vit amin A concentrations, vitamin A was not observed to be associated with mor bidity or mortality.