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Punam Patel April 15th 2011 Group 6 HIV/AIDS INTRODUCTION: HIV (human Immunodeficiency virus) acts by damaging the

immune system which interferes with a persons ability to fight infections. A disease that can be spread from mother to child, during pregnancy, childbirth, or breast-feeding. HIV can take a long time to affect the immune system before it leads into AIDS therefore the progression can be extended. OBJECTIVE: To look at vitamin A and selenium supplementation in pregnant Tanzanian women and if it will impact the immune system and help slow the progression in HIV. For vitamin A look at the HIV related complications in CD4 + cell counts, and viral load. Finely, how selenium see how it will increase hemoglobin concentrations and morbidity. Vitamin A (vitamin) METHODS: 1,078 pregnant women infected with HIV were placed into 4 different groups according to the vitamin they received daily. The main focus was to see if the CD4+ cell count had increased due to supplementation. The first group received vitamin A composed of 30mg of Beta-Carotene + 5,000 IU of Vitamin A. Second group received multivitamins without vitamin. 20mg of B1 and B2, 25 mg of B6, 100mg of niacin, 50 mg of B12, 500mg of vitamin C, 30mg of Vitamin E, and .8 mg of Folic acid. The third group received a combination of multivitamin and vitamin A. The last group acted as a placebo. RESULTS: stated that vitamin A supplementation alone caused a progression to stage 4 or death in 29% (79/272) of the women. Compared to multivitamin this only caused a progression in 25% (67/271) of the women. DISCUSSION: Based on the results shown multivitamin supplementation alone had a greater impact in slowing the progression of HIV/AIDS. The mean CD4+ cell counts were higher by 48 cells per cubic millimeter among women who received multivitamins. Whereas, vitamin A supplementation caused an increase in the risk of progression. Multivitamins significantly reduced oral and gastrointestinal manifestations of HIV disease. SELENIUM (mineral) METHODS:916 women were randomized to either receive a daily dose of 200ug of selenium in tablet form or placebo and asked to take the regimen from enrollment until 6 months postpartum. Hemoglobin concentrations were measured at the beginning, 6 weeks and 6 months postpartum. RESULTS: 627 women had baseline hemoglobin concentration. Only 15 women had an increase in hemoglobin concentration. Overall, selenium did not have an effect on development. DISCUSSION: selenium supplements had no effect on maternal hemoglobin concentrations. However, it did decrease diarrheal morbidity and had no effect on other morbidities. CONCLUSION The main reason for picking Vitamin A and selenium was because of their role in stimulating the immune system since HIV progresses due to the weakness of the immune system. Both vitamin A and selenium proved to be ineffective in helping to the slow the progression of HIV. Vitamin A supplementation had no effect in the progression of the disease or inhibition and it didnt increase CD4+ cells counts either. The mineral Selenium did not have a large beneficial role for women with HIV infection since hemoglobin concentrations stayed the same.
1. 2. Fawzi. Wafaie, M.B., B.S., Dr. P.H. et.al. A randomized trial of multivitamin supplements and HIV disease progression and mortality. New England Journal Medicine 2004; 351:23-32. July 1, 2004. PubMed. Kupka, Roland et.Al. Effect of selenium supplements on hemoglobin concentration and morbidity among HIV-1 infected Tanzanian Women. Clin infect Dis. 2009 May 15; 48 (10): 1475-1478. PubMed.

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