A Randomized Trial of Multivitamin Supplements and HIV Disease Progression and Mortality
Open accessAbstract
BACKGROUND: Results from observational studies suggest that micronutrient status is a determinant of the progression of human immunodeficiency virus (HIV) disease. METHODS: We enrolled 1078 pregnant women infected with HIV in a double-blind, placebo-controlled trial in Dar es Salaam, Tanzania, to examine the effects of daily supplements of vitamin A (preformed vitamin A and beta carotene), multivitamins (vitamins B, C, and E), or both on progression of HIV disease, using survival models. The median follow-up with respect to survival was 71 months (interquartile range, 46 to 80). RESULTS: Of 271 women who received multivitamins, 67 had progression to World Health Organization (WHO) stage 4 disease or died--the primary outcome--as compared with 83 of 267 women who received placebo (24.7 percent vs. 31.1 percent; relative risk, 0.71; 95 percent confidence interval, 0.51 to 0.98; P=0.04). This regimen was also associated with reductions in the relative risk of death related to the acquired immunodeficiency syndrome (0.73; 95 percent confidence interval, 0.51 to 1.04; P=0.09), progression to WHO stage 4 (0.50; 95 percent confidence interval, 0.28 to 0.90; P=0.02), or progression to stage 3 or higher (0.72; 95 percent confidence interval, 0.58 to 0.90; P=0.003). Multivitamins also resulted in significantly higher CD4+ and CD8+ cell counts and significantly lower viral loads. The effects of receiving vitamin A alone were smaller and for the most part not significantly different from those produced by placebo. Adding vitamin A to the multivitamin regimen reduced the benefit with regard to some of the end points examined. CONCLUSIONS: Multivitamin supplements delay the progression of HIV disease and provide an effective, low-cost means of delaying the initiation of antiretroviral therapy in HIV-infected women.
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In a randomized controlled trial of vitamin supplementation in HIV patients, the supplemented group had significantly higher CD8+ and CD4+ T cell counts.
“The vitamin-supplemented group had significantly higher CD8+ and CD4+ T cell counts, as well as lower disease progression (34).”
From Meta-analysis of the gut microbiota in predicting response to cancer immunotherapy in metastatic melanoma (2020) · cites this paper as [34]
In that randomized controlled trial of vitamin supplementation in HIV patients, the supplemented group had lower disease progression.
“The vitamin-supplemented group had significantly higher CD8+ and CD4+ T cell counts, as well as lower disease progression (34).”
From Meta-analysis of the gut microbiota in predicting response to cancer immunotherapy in metastatic melanoma (2020) · cites this paper as [34]
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- Authors
- Fawzi, W. W., Msamanga, G. I., Spiegelman, D., Wei, R., Kapiga, S., Villamor, E., Mwakagile, D., Mugusi, F., Hertzmark, E., Essex, M., & Hunter, D. J.
- Affiliations
- Harvard University (US)
- Muhimbili University of Health and Allied Sciences (TZ)
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2004-07
- Volume
- 351
- Issue
- 1
- Pages
- 23-32
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2128698112
- Cited by
- 446
- References
- 30
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 4 · 2022: 5 · 2021: 7 · 2020: 11 · 2019: 11 · 2018: 5 · 2017: 10 · 2016: 15 · 2015: 20 · 2014: 24 · 2013: 32 · 2012: 33
- FWCI
- 26.67
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Funders
- U.S. Public Health Service (R0132257)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Life Sciences › Immunology and Microbiology › Virology › HIV Research and Treatment
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS drug development and treatment
- Keywords
- multivitamins, HIV disease progression, HIV mortality, vitamin A, beta-carotene, micronutrient supplementation, pregnant women, CD4 count, viral load
- MeSH terms
- Adult, Female, Humans, Pregnancy, Pregnancy Complications, Infectious, Tanzania, Vitamin A, Vitamins, HIV Infections, AIDS-Related Opportunistic Infections, Infectious Disease Transmission, Vertical, Disease Progression, CD4 Lymphocyte Count, Micronutrients, Viral Load, Dietary Supplements
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