Vitamin A Supplementation and Genital Shedding of Herpes Simplex Virus among HIV-1-Infected Women: A Randomized Clinical Trial

• Published in: The Journal of infectious diseases Vol. 189; no. 8; pp. 1466 - 1471
• Main Authors: Baeten, Jared M., McClelland, R. Scott, Corey, Lawrence, Overbaugh, Julie, Lavreys, Ludo, Richardson, Barbra A., Wald, Anna, Mandaliya, Kishorchandra, Bwayo, Job J., Kreiss, Joan K.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 15-04-2004; University of Chicago Press; Oxford University Press
• Subjects: Adult; Biological and medical sciences; CD4 Lymphocyte Count; DNA; DNA, Viral - chemistry; DNA, Viral - genetics; Double-Blind Method; Enzyme-Linked Immunosorbent Assay; Experimentation; Female; Fundamental and applied biological sciences. Psychology; Genitalia; Herpes Genitalis - immunology; Herpes Genitalis - virology; Herpes simplex virus; Herpesvirus 2, Human - physiology; HIV 1; HIV Infections - drug therapy; HIV Infections - virology; HIV-1 - physiology; HIV/AIDS; Human herpesvirus 2; Human immunodeficiency virus 1; Human viral diseases; Humans; Infectious diseases; Medical sciences; Microbiology; Miscellaneous; Placebos; Polymerase Chain Reaction; RNA; Simplexvirus; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Virology; Virus Shedding - drug effects; Vitamin A; Vitamin A - administration & dosage; Vitamin A deficiency; Kenya; Human; Immunopathology; Microbiology; Herpesviridae; Alphaherpesvirinae; Vitamin; AIDS; Genital herpes; Immune deficiency; Retinol; Infection; Virus; Viral disease; Female; Human herpesvirus 1
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/383049

Cross-sectional analyses have associated vitamin A deficiency with genital shedding of herpes simplex virus (HSV) among human immunodeficiency virus type 1 (HIV-1)-infected women. A randomized clinical trial of vitamin A supplementation given daily for 6 weeks was conducted among 376 women in Mombasa, Kenya, who were coinfected with HSV-2 and HIV-1. At follow-up, there was no significant difference in the detection of genital HSV DNA between women receiving vitamin A supplementation and women receiving placebo (40% vs. 44%, respectively; P = .5) Among women shedding HSV, there was no significant difference in the mean HSV DNA quantity between the group that received vitamin A supplementation and the group that received placebo (4.51 vs. 4.67 log10 copies/swab; P = .6). HSV shedding was associated with significantly higher vaginal and cervical HIV-1 shedding, even after controlling for the plasma HIV-1 load and the CD4 count. Vitamin A supplementation is unlikely to decrease HSV shedding and infectivity.