Vitamin A Increases HIV Virus in Breast Milk

Vitamin A and beta-carotene supplements are unsafe for HIV-positive women who breastfeed because they may boost the excretion of HIV in breast milk—thereby in­creas­ing the chances of transmitting the infection to the child, as 2 new studies suggest. Epidemiologist Dr. Ed­uardo Villamor of the Uni­versity of Michigan (U-M) School of Public Health said the transmission of HIV through breastfeeding happens be­cause breast milk carries viral particles that the baby ingests. Supplementing HIV-positive women with vi­tamin A and beta-carotene ap­pears to in­crease the amount of the virus in milk. This may be partly because the same nu­trients raise the risk of developing subclinical mastitis, an in­flammatory condition that causes blood plasma to leak into the mammary gland and viral particles to then leak into the milk, he said. Dr. Vil­lamor’s findings appear in 2 separate articles in the Amer­ican Journal of Clinical Nu­trition and the Journal of Nu­trition. The results are significant because they provide biological explanations for a previous report that supplementation with these nutrients increased chances of mother-to-child HIV transmission.
     “So there are now strong arguments to consider the im­plications of supplementation to pregnant or lactating wom­en who are HIV-positive,” said Dr. Villamor. “It does not look like it’s a safe intervention for them.” In one of the studies, 1,078 HIV-infected women were divided into 4 groups. The test groups received either 5,000 IU of vitamin A and 30 mg of beta-carotene every day during gestation and the lactation period, or a control regimen. The dose for beta-car­o­tene was higher than the amount usually provided by the diet, according to Dr. Vil­lamor. Smaller doses might not have the same effect.