Vitamin profile of pregnant women living with HIV/AIDS

Abstract

Summary Background & aims Maternal adequate micronutrient storage contributes to reducing morbidity and mortality of their children during the first two years of life. This study aimed at identifying hypovitaminosises among Brazilian HIV infected pregnant women and investigating their association with nutritional status, CD4 + cell counts, viral load and HAART use. Methods Cross-sectional study with 49 HIV infected pregnant women. Inclusion criteria followed: (1) HIV infection laboratory confirmation (HIV and HIV RNA); (2) Confirmed pregnancy, (3) Age above 14 years old; (4) Written consent. Exclusion criteria consisted of at least one of the following: (1) Use of any nutritional/multivitamin supplement (except iron or folinic acid); (2) Presence of nutritional counseling during the current pregnancy; (3) Presence of acute phase opportunistic diseases associated with HIV infection. Patients were evaluated according to anthropometric (gestational BMI, based on the curve of weight gain corrected for gestational age) and laboratory parameters (analysis of vitamin A, E, C, D, B6 and B12, CD4 + cell count, viral load, lipid profile, homocysteine and C-reactive protein). Blood samples were collected in 5 mL dry tubes with separating gel, after 12 h fasting. Vitamin profile was measured by HPLC. Results were classified according to abnormal ranges proposed for pregnant women. Results Low gestational weight was higher in women with CD4 + 3 [OR = 12.5; 95% CI 2,00,77,89; p = 0.007]. Prevalence of abnormal serum concentrations was 38.8% for vitamin D, 14.3% for vitamin A, 22.4% for vitamin E, 12.2% for vitamin C, 53.2% for vitamin B6 and 32.6% for vitamin B12. C-reactive protein was associated with vitamin E [OR = 0.23, 95% CI 0.053, 1.01, p = 0.03] and A [OR = 0.15, 95% CI 0.028, 0.84, p = 0.03]. Homocysteine was not associated with lower vitamin concentrations. Women with optimal B12 levels were 4.3 times more likely to have CD4 + >200 cells/mm³ [OR = 0.23, 0.58 to 0.905, 95% CI, p = 0.03]. HIV viral load has not been significantly associated with vitamin concentrations. Conclusions There was high prevalence of abnormal concentrations of vitamin A, D, B6 and B12. Nutritional status was associated with CD4 + cell count and vitamins were associated with immune function and inflammatory markers. There is need for more studies on this matter in Brazil. Vitamin serum levels should be monitored in these patients during prenatal care, and results underscore the importance of early nutritional intervention to ensure favorable pregnancy and birth outcomes, specially regarding the vitamin profile described here.