Multivitamins retard HIV progression, study finds

A daily intake of multivitamins can significantly delay the progress of the HIV/AIDS virus, according to the results of a study of HIV-infected women in Tanzania, the Harvard School of Public Health reported on Wednesday. "Our findings should encourage the use of multivitamin supplements as supportive care to those infected with HIV," the Harvard School of Public Health said in a statement issued from Boston, Massachusetts. Researchers from the Harvard School of Public Health and Tanzania's Muhimbili University College of Health Services in Dar es Salaam found that women taking multivitamins (vitamins B-complex, C and E) significantly delayed the progression of the HIV disease compared to those in the study who received a placebo instead. The study's results appear in the 1 July issue of The New England Journal of Medicine. The Harvard School of Public Health reported that by the end of 2003, 40 million people worldwide had been infected with HIV, with fewer than 8 percent of the six million patients with advanced symptoms of the disease who were eligible for anti-retroviral drug therapy receiving it. It said the "Treat 3 million by 2005" initiative by the World Health Organisation (WHO) was designed to increase access to treatment. "According to this plan, and country-specific standards of care, individuals with advanced disease will receive anti-retroviral therapy, while those in earlier stages will be monitored and provided supportive care," the school reported. During the study in Tanzania, researchers randomly assigned 1,078 HIV-infected pregnant women to receive a daily dose of one of four regimens: vitamin A alone; multivitamins excluding A (with vitamin B complex and vitamins C and E); multivitamins containing vitamin A; or a placebo. The women were enrolled over a two-year period beginning in April 1995 and were followed until the end of the study in August 2003. "All women received standard doses of antenatal folic acid and iron, and all children received six-monthly doses of vitamin A, as per standard of care in Tanzania," the school reported. It added that anti-retroviral therapy was unavailable at the time of the study to the majority of women in Tanzania, including those who were eligible for participation in the study. During the course of the study, 299 of the 1,078 women either died from AIDS-related causes or progressed to WHO stage 4 (equivalent to AIDS): Among the 271 women who received multivitamins, 67 (24.7 percent) progressed to WHO stage 4 or died of AIDS-related causes; among women who received multivitamins with vitamin A, the total was 70 (26.1 (percent) of the 268; for those who received vitamin A alone, it was 79 (29 percent); and of 272 who received the placebo, it was 83 (31.1 percent) who progressed to WHO stage 4 or died from AIDS-related causes. Moreover, the school reported, women in the study who took multivitamins had "higher CD4 immune cell counts, lower viral loads, and reduced complications of HIV infection, including oral thrush, oral ulcers, difficulty in swallowing, diarrhoea and fatigue". "Our data suggest that multivitamins delay the onset of disease progression and thus extend the time until such therapy is necessary," Wafaie Fawzi, the lead author of the study and associate professor of nutrition and epidemiology at the Harvard School of Public Health, was quoted as saying. He added: "Multivitamin supplementation is inexpensive: [US] $15 per person per year. Introducing these supplements would enhance compliance with monitoring prior to clinical eligibility for anti-retroviral drugs, preserve these drugs for later stages of the disease, avert adverse events associated with them, and result in better quality of life among HIV-infected persons, and significant treatment-related cost savings." The National Institute of Child Health and Human Development and the Fogarty International Centre at the National Institutes of Health supported the study.