Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2013 Aug 13;16(1):18022.
doi: 10.7448/IAS.16.1.18022.

Multivitamin supplementation improves haematologic status in children born to HIV-positive women in Tanzania

Enju Liu  1 , Christopher Duggan, Karim P Manji, Roland Kupka, Said Aboud, Ronald J Bosch, Rodrick R Kisenge, James Okuma, Wafaie W Fawzi
Affiliations
Randomized Controlled Trial

Multivitamin supplementation improves haematologic status in children born to HIV-positive women in Tanzania

Enju Liu et al. J Int AIDS Soc. .

Abstract

Introduction: Anaemia is prevalent among children born to HIV-positive women, and it is associated with adverse effects on cognitive and motor development, growth, and increased risks of morbidity and mortality.

Objective: To examine the effect of daily multivitamin supplementation on haematologic status and mother-to-child transmission (MTCT) of HIV through breastfeeding.

Methods: A total of 2387 infants born to HIV-positive women from Dar es Salaam, Tanzania were enrolled in a randomized, double-blind, placebo-controlled trial, and provided a daily oral supplement of multivitamins (vitamin B complex, C and E) or placebo at age 6 weeks for 24 months. Among them, 2008 infants provided blood samples and had haemoglobin concentrations measured at baseline and during a follow-up period. Anaemia was defined as haemoglobin concentrations <11 g/dL and severe anaemia <8.5 g/dL.

Results: Haemoglobin concentrations among children in the treatment group were significantly higher than those in the placebo group at 12 (9.77 vs. 9.64 g/dL, p=0.03), 18 (9.76 vs. 9.57 g/dL, p=0.004), and 24 months (9.93 vs. 9.75 g/dL, p=0.02) of follow-up. Compared to those in the placebo group, children in the treatment group had a 12% lower risk of anaemia (hazard ratio (HR): 0.88; 95% CI: 0.79-0.99; p=0.03). The treatment was associated with a 28% reduced risk of severe anaemia among children born to women without anaemia (HR: 0.72; 95% CI: 0.56-0.92; p=0.008), but not among those born to women with anaemia (HR: 1.10; 95% CI: 0.79-1.54; p=0.57; p for interaction=0.007). One thousand seven hundred fifty three infants who tested HIV-negative at baseline and had HIV testing during follow-up were included in the analysis for MTCT of HIV. No association was found between multivitamin supplements and MTCT of HIV.

Conclusions: Multivitamin supplements improve haematologic status among children born to HIV-positive women. Further trials focusing on anaemia among HIV-exposed children are warranted in the context of antiretroviral therapy.

Keywords: Tanzania; anaemia; haemoglobin; mother-to-child transmission; multivitamins; randomized controlled trial.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Sample sizes for analyses of haemoglobin (HB), anaemia (HB<11 g/dL), and severe anaemia (HB<8.5 g/dL).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Totin D, Ndugwa C, Mmiro F, Perry RT, Jackson JB, Semba RD. Iron deficiency anaemia is highly prevalent among human immunodeficiency virus-infected and uninfected infants in Uganda. J Nutr. 2002;132(3):423–9. - PubMed
    1. Feiterna-Sperling C, Weizsaecker K, Buhrer C, Casteleyn S, Loui A, Schmitz T, et al. Hematologic effects of maternal antiretroviral therapy and transmission prophylaxis in HIV-1-exposed uninfected newborn infants. J Acquir Immune Defic Syndr. 2007;45(1):43–51. - PubMed
    1. Clark TD, Mmiro F, Ndugwa C, Perry RT, Jackson JB, Melikian G, et al. Risk factors and cumulative incidence of anaemia among human immunodeficiency virus-infected children in Uganda. Ann Trop Paediatr. 2002;22(1):11–7. - PubMed
    1. Fawzi WW, Msamanga GI, Kupka R, Spiegelman D, Villamor E, Mugusi F, et al. Multivitamin supplementation improves hematologic status in HIV-infected women and their children in Tanzania. Am J Clin Nutr. 2007;85(5):1335–43. - PubMed
    1. Smuts CM, Lombard CJ, Benade AJ, Dhansay MA, Berger J, Hop le T, et al. Efficacy of a foodlet-based multiple micronutrient supplement for preventing growth faltering, anemia, and micronutrient deficiency of infants: the four country IRIS trial pooled data analysis. J Nutr. 2005;135(3):631S–8S. - PubMed

Publication types

LinkOut - more resources