VITAMINS IN HIV DISEASE PROGRESSION AND VERTICAL TRANSMISSION

Human immunodeficiency virus (HIV) infection is a major public health problem worldwide, but particularly in subsaharan Africa and Asia. Num erous observational studies report inverse associations between vitami n status, measured biochemically or as levels of dietary intake, and t he risk of disease progression or vertical transmission. Evidence to s upport these findings has been obtained from a few randomized placebo- controlled trials. In this paper, we review studies that examined the role of vitamins A, B, C, D, and E in HIV disease progression and tran smission, and we discuss the potential mechanisms of action of these v itamins. Adequate vitamin intake leads to enhancement of epithelial in tegrity and systemic immunity and could contribute to improved clinica l condition among HIV-infected subjects and reduce vertical transmissi on by reducing the risk and severity of opportunistic infection and re ducing viral load in blood. Adequate vitamin status may also reduce ve rtical transmission through the intrapartum and breastfeeding routes b y reducing HIV viral load in lower genital secretions and breast milk, respectively. Vitamin supplements may be one of a few potential treat ments that are inexpensive enough to be made available to HIV-infected persons in developing countries.