Vitamin A, iron and zinc status of HIV-1 infected pregnant women and their young infants

Abstract

Malnutrition is a frequent event during the course of Human Immunodeficiency Virus Infection and has been associated with micronutrients deficiencies. Micronutrients deficiencies may accelerate disease progression as well as increase mortality rate. Maternal malnutrition has been associated with increased morbidity and mortality in babies and infants. These events can vary depending on the severity of maternal nutritional deficiency. Studies conducted by our group have found indirect evidences of deficiency of micronutrients in HIV-infected pregnant women despite of the known required supplementation during pregnancy. Association was found between maternal body mass index and infants anthropometric variables, adjusted for covariates. It was also found high proportion of retinol, b-carotene and a-tocopherol deficiencies in three years old children born to HIV-infected mothers. In another randomized controlled study, the use of supplemented food formulas by Brazilian babies, during the first six months of age, lead to a more pronounced increase in their weight and height, when compared to babies receiving conventional food formulas. Data concerning micronutrients status in Brazilian HIV-infected pregnant women and in their babies are scarce. The main objectives of the present study are to describe anthropometric data and serum levels of retinol, a-tocopherol, zinc and iron in HIV-infected pregnant women and their babies, and their interrelationships. The present study will be conducted based on data and blood samples that have been obtained in three Brazilian Centers according to a Multicentric International Protocol LILAC (NISDI Longitudinal Study in Latin American Countries), a prospective cohort study investigating HIV-infected mothers and their children in Latin America. The study will describe serum levels of retinol, a-tocopherol, zinc and iron (assessed by hemoglobin, erythrocyte mean corpuscular volume and ferritin) in newborn of HIV-infected mothers, at birth, at six to twelve weeks of age and at six months of age. Correlations with micronutrients serum levels of their mothers at delivery will be verified. The study also intends to evaluate if micronutrients deficiencies eventually found in infants could be corrected after a six months of a conventional food intake. Some variables supposed to affect nutritional status of the babies, such as those related to HIV infection and morbidity in pregnant woman, will also be considered during data analysis. (AU)