Vitamin A supplements for reducing mother-to-child HIV transmission
UPDATED
Charles S Wiysonge1, Valantine N Ndze2, Eugene J Kongnyuy3, Muki S Shey4
1. South African Medical Research Council, Cochrane South Africa, Cape Town, Western Cape, South Africa
2. Stellenbosch University, Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Cape Town, South Africa
3. Reproductive Health Solutions, Salisbury, UK
4. University of Cape Town, Health Sciences Faculty, Clinical Infectious Diseases Research Initiative (CIDRI), Cape Town, Western Cape, South Africa
Wiysonge CS, Ndze VN, Kongnyuy EJ, Shey MS. Vitamin A supplements for reducing mother-to-child HIV transmission. Cochrane Database of Systematic Reviews 2017, Issue 9. Art. No.: CD003648. DOI: 10.1002/14651858.CD003648.pub4
Access the full-text article here: DOI/10.1002/14651858.CD003648.pub4/full
What is the aim of this review?
The main aim of this Cochrane Review was to assess the effects of giving vitamin A supplements to HIV-positive women, during pregnancy or after delivery, or both, on the risk of mother-to-child transmission of HIV infection. Cochrane researchers collected and examined all relevant studies to answer this question and included five trials. This is an update of a review last published in 2011.
What is the key message of this review?
Giving vitamin A supplements to HIV-positive women, during pregnancy or after delivery, or both, probably makes little or no difference to the risk of mother-to-child transmission of HIV (moderate certainty evidence).
What are the main results of the review?
Five trials met the inclusion criteria of the review. Two trials were from South Africa and one trial each from Malawi, Tanzania, and Zimbabwe. The trials compared women receiving vitamin A supplements to women not receiving such supplements. None of the participants received antiretroviral therapy (ART).
The review shows that in women living with HIV infection and not on ART:
- giving vitamin A supplements to HIV-positive women during pregnancy, immediately after delivery, or both, probably has little or no effect on the risk of mother-to-child transmission of HIV (moderate certainty evidence) and may have little or no effect on child death by two years of age (low certainty evidence);
- giving vitamin A supplements to HIV-positive women during pregnancy may increase the mean birthweight (low certainty evidence) and probably reduces the number of low birthweight babies (moderate certainty evidence), but it is uncertain whether the intervention has an effect on the number of preterm births, stillbirths, or deaths among the women (very low certainty evidence).
The intervention has largely been superseded by ART, which is widely available and effective in preventing mother-to-child transmission of HIV.
How up-to-date is this review?
The review authors searched for studies up to 25 August 2017.