New research has found no benefit of high-dose multivitamins for patients on HIV treatment.
Although previous studies have found a benefit on CD4 counts, disease progression and mortality in patients not yet started on highly active antiretroviral therapy (HAART), it is unclear how safe high-dose supplements are for people on HAART.
A team from Harvard School of Public Health, Boston, USA, looked at its effect on 3,418 HIV patients in Tanzania starting on HAART. For 15 months, patients took either high or standard levels of vitamin B complex, vitamin C, and vitamin E.
The study was stopped early when it was noticed that patients on the high-dose supplement had increased levels of alanine transaminase, which is linked to liver problems.
Overall, high-dose supplementation did not reduce the risk of HIV disease progression or death compared with a standard dose. In the Journal of the American Medical Association today (October 17), Dr Sheila Isanaka and colleagues report that the risk of HIV progression or death was 72 per cent in both groups.
"High-dose supplementation had no effect on CD4 count, plasma viral load, body mass index, or haemoglobin level concentration, but increased the risk of alanine transaminase elevations by 44 per cent," they write.
"Although the provision of high-dose vitamin supplements has been found safe and efficacious among HIV-infected patients not receiving HAART, the results from this study show that the safety and efficacy of nutritional interventions in the context of potent combination therapies such as HAART need to be further examined."
Dr Isanaka calls for future studies to examine whether supplements might be of benefit if they are given with food, in lower doses, or only after patients have acclimatised to HAART therapy.
Effect of High-Dose vs Standard-Dose Multivitamin Supplementation at the Initiation of HAART on HIV Disease Progression and Mortality in Tanzania: A Randomized Controlled Trial. Isanaka, S. et al. The Journal of the American Medical Association October 17 2012 doi:10.1001/jama.2012.13083
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