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Prevalence of Vitamin A Deficiency and Associations with Socioeconomic Status in Lactating HIV‐infected Malawian Mothers
Author(s) -
Patel K. D.,
Bentley M. E.,
Flax V. L.,
ShahabFerdows S.,
Allen L. H.,
Chasela C. S.,
Kayira D.,
Tegha G.,
Jamieson D. J.,
Horst C. M.,
Adair L. S.
Publication year - 2013
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.27.1_supplement.619.8
Subject(s) - breastfeeding , medicine , socioeconomic status , population , vitamin , logistic regression , vitamin a deficiency , pregnancy , immunology , physiology , cross sectional study , odds ratio , environmental health , retinol , pediatrics , biology , pathology , genetics
Vitamin A deficiency (VAD) is a concern in HIV+ women because it lowers epithelial integrity, the immune response, and red blood cell production, leading to greater risk of negative health outcomes. A subsample of Malawian lactating HIV+ mothers enrolled in the Breastfeeding, Antiretrovirals, and Nutrition Study, with demographic and plasma retinol binding protein (RBP) data (n=623), was evaluated to understand prevalence of VAD (serum RBP ≤1.17 μmol/L) and the correlation between socioeconomic status (SES) and VAD. The Thurnham method was used to adjust RBP values for inflammation, using C‐reactive protein>;5 mg/L and α‐1‐acid glycoprotein>;1 g/L. The prevalence of VAD was 71% at 2 or 6 weeks postpartum and 77% at 24 weeks postpartum and did not change when adjusted for inflammation. Logistic regression models were used to calculate odds of deficiency for each SES indicator. Lower maternal age and having no paid work were associated with higher levels of VAD (p<0.05), but VAD was unrelated to other SES indicators. The high level of VAD in this population, especially among younger and poorer mothers, suggests the need for vitamin A supplementation, but concerns that supplementation is associated with increased viral shedding and a higher risk of mother‐to‐child HIV transmission need to be weighed in settings with high HIV prevalence. Funding: CDC(U48‐ DP000059 –01); Gates Foundation(OPP53107)