TY - JOUR
T1 - Vitamin A deficiency and increased mortality among human immunodeficiency virus-infected adults in Uganda
AU - Langi, Peter
AU - Semba, Richard D.
AU - Mugerwa, Roy D.
AU - Whalen, Christopher C.
N1 - Funding Information:
Peter Langi designed the study, conducted the analysis, and prepared the manuscript. Richard Semba provided laboratory assistance and contributed to the manuscript. Roy Mugerwa provided expertise on tuberculosis and contributed to the manuscript. Christopher Whalen was Principal Investigator of the original clinical trial, provided guidance for this ancillary analysis, and contributed to the manuscript. This study was supported in part by grants from AIDS International Training and Research Program, Fogarty International Center (TW-92-02), and NIH HD30042, HD32247, AI41956; The Centers for Disease Control and Prevention ADEPT/HIV-Related Tuberculosis Demonstration Project (478/CCU506716-04), and the United States Agency for International Development (Cooperative Agreement DAN-0045-A-5094-00). The authors thank the patients and families who participated in the study, Dr. Thomas Aisu, John L. Johnson, and Peter Nsubuga, the Makerere University/Case Western Reserve University Collaboration Data Management Center in Kampala; the Joint Clinical Research Centre, Kampala, Uganda; the AIDS Information Centre, Kampala, Uganda; the staff of the Wandegeya National Clinical Laboratory, and Yin Lan, MS for measurements of serum vitamin A concentrations.
PY - 2003/5/1
Y1 - 2003/5/1
N2 - The specific aims of the study were to determine the prevalence of vitamin A deficiency and to examine the relationship between vitamin A deficiency and mortality among human immunodeficiency virus (HIV)-infected adults in sub-Saharan Africa. A prospective cohort study was conducted at the outpatient clinic of Mulago Hospital, Kampala, Uganda, among HIV-infected adults enrolled in the placebo arms of a randomized clinical trial to prevent Mycobacterium tuberculosis infection. Of 519 subjects at enrollment, 186 (36%) had serum vitamin A concentrations consistent with deficiency (<1.05 μmol/L). During follow-up (median 17 months), the mortality among subjects with and without vitamin A deficiency at enrollment was 30% and 17%, respectively (P = 0.01). In a multivariate model adjusting for CD4+ lymphocyte count, age, sex, anergy status, body mass index, and diarrhea, vitamin A deficiency was associated with a significantly elevated risk of death [relative risk (RR) = 1.78, 95% confidence interval (CI) 1.2-2.6]. Vitamin A deficiency is common among HIV-infected adults in this sub-Saharan population and is associated with higher mortality.
AB - The specific aims of the study were to determine the prevalence of vitamin A deficiency and to examine the relationship between vitamin A deficiency and mortality among human immunodeficiency virus (HIV)-infected adults in sub-Saharan Africa. A prospective cohort study was conducted at the outpatient clinic of Mulago Hospital, Kampala, Uganda, among HIV-infected adults enrolled in the placebo arms of a randomized clinical trial to prevent Mycobacterium tuberculosis infection. Of 519 subjects at enrollment, 186 (36%) had serum vitamin A concentrations consistent with deficiency (<1.05 μmol/L). During follow-up (median 17 months), the mortality among subjects with and without vitamin A deficiency at enrollment was 30% and 17%, respectively (P = 0.01). In a multivariate model adjusting for CD4+ lymphocyte count, age, sex, anergy status, body mass index, and diarrhea, vitamin A deficiency was associated with a significantly elevated risk of death [relative risk (RR) = 1.78, 95% confidence interval (CI) 1.2-2.6]. Vitamin A deficiency is common among HIV-infected adults in this sub-Saharan population and is associated with higher mortality.
KW - Acquired immmunodeficiency syndrome
KW - Human immunodeficiency virus
KW - Mortality
KW - Retinol
KW - Uganda
KW - Vitamin A
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U2 - 10.1016/S0271-5317(03)00006-X
DO - 10.1016/S0271-5317(03)00006-X
M3 - Article
AN - SCOPUS:0038583784
SN - 0271-5317
VL - 23
SP - 595
EP - 605
JO - Nutrition Research
JF - Nutrition Research
IS - 5
ER -