The Role of Multivitamins in Paediatric HIV Management in Nigeria: A Randomized Controlled Study

Background The signature of Human Immunodeficiency Virus (HIV) infection is immune deficiency Management involves the use of combination antiretroviral drugs Multivitamins are also being used A vicious cycle between micronutrient deficiency, immune deficiency and HIV disease progression has been reported in a number of studies

Vicious cycle between HIV infection and micronutrient deficiencies Increased Morbidity HIV related diminished nutritional intakes and malabsorption Micronutrient deficiencies Oxidative stress and Immunosuppression Increased viral loads, decreased CD4 counts

Research objectives To determine the effect of multivitamins on health outcomes To determine if higher strength multivitamins may be able to provide better health outcomes compared to lower strength multivitamins -Primary outcome: CD4 count -Secondary outcomes: Haemoglobin (Hb) levels

Methodology Group A multivitamin Group B multivitamin Group C multivitamin 7 micronutrients at RDA 22 micronutrients at RDA 22 micronutrients at 3RDA

Results Significant increase in Hb conc. after 3 months No significant change in CD4 count after 3 months

Results significant reduction in prevalence of anaemia after 3 months multivitamin use P= 0.004 Anaemia status at baseline Anaemia status after 3 months

Results No change in prevalence of immune deficiency after 3 months, P=0.405 Immune status at baseline Immune status after 3 months

RESULTS Multi-micronutrient group assignment did not influence outcomes

Discussion After 3 months of multivitamin use, no significant increase in CD4 count was observed. Hb concentration was increased and prevalence of anaemia was reduced. So far, this study therefore supports multivitamin use in PLHIV.

Thank you.

References Fawzi, W., Msamanga, G., Kupka, R., Spiegelman, D., Villamor, E., Mugusi, F., Wei, R. and Hunter, D. (2007) ‘Multivitamin supplementation improves hematologic status in HIV-infected women and their children in Tanzania’, The American journal of clinical nutrition., 5(85) National Agency for the Control of AIDS (NACA) (2015) Global AIDS response. Country Progress Report, Nigeria GARPR 2015. Available at: http://www.unaids.org/en/regionscountries/countries/nigeri a Semba, R. and Tang, A. (1999) ‘Micronutrients and the pathogenesis of human immunodeficiency virus infection.’, The British journal of nutrition., 3(81)