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Effect of multiple micronutrient supplementation on survival of HIV-infected children in Uganda: a randomized, controlled trial

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dc.contributor.author Ndeezi, Grace eng
dc.contributor.author Tylleskär, Thorkild eng
dc.contributor.author Ndugwa, Christopher M. eng
dc.contributor.author Tumwine, James K. eng
dc.date.accessioned 2011-04-08T12:29:13Z
dc.date.available 2011-04-08T12:29:13Z
dc.date.issued 2010-06-03 eng
dc.identifier.citation Journal of the International AIDS Society 13(18) en_US
dc.identifier.issn 1758-2652 eng
dc.identifier.uri http://hdl.handle.net/1956/4643
dc.description.abstract Background: Micronutrient deficiencies compromise the survival of HIV-infected children in low-income countries. We assessed the effect of multiple micronutrient supplementation on the mortality of HIV-infected children in Uganda. Methods: In a randomized, controlled trial, 847 children aged one to five years and attending HIV clinics in Uganda were stratified by antiretroviral therapy (ART, n = 85 versus no ART, n = 762). The children were randomized to six months of either: twice the recommended dietary allowance of 14 micronutrients as the intervention arm (vitamins A, B1, B2, niacin, B6, B12, C, D and E, folate, zinc, copper, iodine and selenium); or the standard recommended dietary allowance of six multivitamins (vitamins A, D2, B1, B2, C and niacin) as a comparative "standard-of-care" arm. Mortality was analyzed at 12 months of follow up using Kaplan Meier curves and the log rank test. Results: Mortality at 12 months was 25 out of 426 (5.9%) children in the intervention arm and 28 out of 421 (6.7%) in the comparative arms: risk ratio 0.9 (95% CI 0.5 - 1.5). Two out of 85 (2.4%) children in the ART stratum died compared with 51 out of 762 (6.7%) in the non-ART stratum. Of those who died in the non-ART stratum, 25 of 383 (6.5%) were in the intervention arm and 26 of 379 (6.9%) in the comparative arm; risk ratio 1.0 (95% CI 0.6 - 1.6). There was no significant difference in survival at 12 months (p = 0.64, log rank test). In addition, there was no significant difference in mean weight-for-height at 12 months; 0.70 ± 1.43 (95% CI 0.52 - 0.88) for the intervention versus 0.59 ± 1.15 (95% CI 0.45 - 0.75) in the comparative arm. The mean CD4 cell count; 1024 ± 592 (95% CI 942 - 1107) versus 1060 ± 553 (95% CI 985 - 1136) was also similar between the two groups. Conclusions: Twice the recommended dietary allowance of 14 micronutrients compared with a standard recommended dietary allowance of six multivitamins for six months was well tolerated, but it did not significantly alter mortality, growth or CD4 counts. Future intervention studies should carefully consider: (1) the composition and dosing of the supplements; and (2) the power needed to detect a difference between arms. en_US
dc.language.iso eng eng
dc.publisher BioMed Central eng
dc.relation.ispartof <a href="http://hdl.handle.net/1956/5153" target="_blank">Multiple micronutrient supplementation in HIV-infected children. A randomised trial among children aged 1-5 years in Uganda</a> en
dc.rights Attribution CC BY eng
dc.rights.uri http://creativecommons.org/licenses/by/2.0 eng
dc.title Effect of multiple micronutrient supplementation on survival of HIV-infected children in Uganda: a randomized, controlled trial eng
dc.type Journal article eng
dc.type Peer reviewed eng
dc.subject.nsi VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Communicable diseases: 776 eng
dc.rights.holder Copyright 2010 Ndeezi et al; licensee BioMed Central
dc.rights.holder Ndeezi et al; licensee BioMed Central eng
dc.type.version publishedVersion eng
bora.peerreviewed Peer reviewed eng
bora.cristinID 349235 eng
bibo.doi http://dx.doi.org/10.1186/1758-2652-13-18 eng
dc.identifier.cristinID 349235 eng
dc.identifier.doi http://dx.doi.org/10.1186/1758-2652-13-18


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