VITAMIN-A LEVELS IN NORMAL AND HIV-INFECTED PREGNANT-WOMEN

Objective. To establish serum vitamin A levels in pregnant women from a low socio-economic population in which the prevalence of human immun odeficiency virus (HIV) infection is known to be high. Background. Vit amin A deficiency occurs frequently in asymptomatic HIV infection and is associated with increased risk of mother-to-child transmission of H IV during pregnancy, delivery and lactation. Setting. King Edward VIII Hospital, Durban, South Africa. Study design. Cross-sectional study. Patients and methods. A total of 248 patients were studied in three gr oups. Group 1 consisted of HIV antibody-positive pregnant women, group 2 consisted of HIV anti-positive non-pregnant women, and group 3 cons isted of HIV antibody-positive women within 24 hours of delivery. Cont rol groups consisted of HIV-uninfected women matched for age, parity a nd, where applicable, period of gestation. Vitamin A (serum retinol) w as measured by reverse-phase liquid chromatography. Results. The mean vitamin A level in all women studied was 36.2 mu g/dl (range 3-99 mu g /dl); 123 of 248 (49.6%) had inadequate levels of vitamin A (< 30 mu g /dl), while 68 (27.4%) had levels consistent with vitamin A deficiency . Vitamin A levels in the HIV-infected non-pregnant women (29.3 vs 47. 1 mu g/dl; P = 0.007) were significantly lower than those in the respe ctive HIV-uninfected control groups. In addition the HIV-uninfected pr egnant women had significantly lower vitamin A levels than their uninf ected non-pregnant counterparts (32.8 v. 47.1 mu g/dl; P = 0.002). No significant differences in vitamin A levels were observed between HIV- infected and uninfected pregnant women (30.4 v. 32.8 mu g/dl). Vitamin A levels of < 20 mu g/dl were observed in 28.4% of all the pregnant w omen, and 40% of the infected women post-delivery. Conclusion. This st udy confirms that vitamin A deficiency is a common health problem amon g black South African women during pregnancy and associated with HIV i nfection.