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Review
. 2011 Dec;94(6):1683S-1689S.
doi: 10.3945/ajcn.111.011999. Epub 2011 Nov 16.

Micronutrients in HIV/AIDS: is there evidence to change the WHO 2003 recommendations?

Janet E Forrester  1 , Kevin A Sztam
Affiliations
Review

Micronutrients in HIV/AIDS: is there evidence to change the WHO 2003 recommendations?

Janet E Forrester et al. Am J Clin Nutr. 2011 Dec.

Abstract

To establish whether there is new evidence to inform changes to WHO 2003 recommendations for micronutrient intake in persons with HIV/AIDS, we conducted a narrative review of the literature published from 2003 to 2010. Although the review focused on new randomized controlled trials of multiple micronutrients in HIV-infected adults, including pregnant and lactating women, we also considered randomized trials of single micronutrients. The review found that there are few published randomized controlled trials of micronutrients in HIV-infected persons and that most trials used high-dose multiple micronutrient supplementation. The trials were heterogeneous with respect to the composition and dose of micronutrients used and the target population studied. Despite this heterogeneity, 5 of 6 trials that used high-dose multiple micronutrients showed benefits in terms of either improved CD4 cell counts or survival. However, many of these trials were small and of short duration, and therefore the long-term risks and benefits of high-dose multiple micronutrients are not established. The current WHO recommendation for an intake of micronutrients at Recommended Dietary Allowance amounts continues to be a reasonable target for persons with clinically stable HIV infection. In light of new data that show adverse effects of high-dose vitamin A, the current recommendation for a single high dose of vitamin A in HIV-infected women within 6 wk of delivery should be reviewed.

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Figures

FIGURE 1.
FIGURE 1.
Flowchart of citations included in the narrative review of multiple micronutrient trials in HIV-infected adolescents and adults.
See this image and copyright information in PMC

References

    1. WHO Nutrient requirements for people living with HIV/AIDS: report of a technical consultation, World Health Organization, Geneva, 13-15 May 2003. Available from: http://www.who.int/nutrition/publications/Content_nutrient_requirements.pdf (cited 5 July 2010)
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