High-dose supplement not beneficial for patients in Tanzania initiating HAART; may increase ALT levels
TUESDAY, Oct. 16 (HealthDay News) -- High-dose vitamin supplementation does not reduce HIV disease progression or death among HIV patients initiating highly active antiretroviral therapy (HAART) in Tanzania, according to a study published in the Oct. 17 issue of the Journal of the American Medical Association.
Sheila Isanaka, Sc.D., from the Harvard School of Public Health in Boston, and colleagues randomly assigned 3,418 patients with HIV initiating HAART in Tanzania to receive either daily oral supplements of vitamin B complex, vitamin C, and vitamin E at high levels or standard multivitamin supplementation at the recommended dietary allowance, for 24 months.
The study was halted early due to evidence of increased levels of alanine transaminase (ALT) in patients receiving the high-dose multivitamin supplementation. During a median follow-up of 15 months, the researchers identified 2,374 HIV disease progression events and 453 deaths. Compared to standard-dose supplementation, high-dose supplementation did not lower the risk of HIV disease progression or death, with the absolute risk of HIV progression or death 72 percent in both groups. CD4 count, plasma viral load, body mass index, and hemoglobin level concentration were not affected by high-dose supplementation, but there was an increased risk of ALT elevations (risk ratio, 1.44) when compared to standard-dose supplementation.
"In adults receiving HAART, use of high-dose multivitamin supplements compared with standard-dose multivitamin supplements did not result in a decrease in HIV disease progression or death but may have resulted in an increase in ALT levels," the authors write.
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