Multivitamin supplementation in HIV infected adults initiating antiretroviral therapy in Uganda: the protocol for a randomized double blinded placebo controlled efficacy trial

BMC Infectious Diseases

Wafaie W Fawzi²  Yukari C Manabe³  Molin Wang⁷  Donna Spiegelman⁷  Ferdinand Mugusi⁶  Henry Wamani⁵  Fred Wabwire-Mangen⁵  Rachel Kyeyune⁴  Danstan Bagenda⁵  Amara E Ezeamama¹  David Guwatudde⁵ 

[1] Department of Nutrition, Harvard School of Public Health, Boston, MA, USA;Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA;Department of Medicine, Division of Infectious Diseases, John Hopkins University, Baltimore, MD, USA;Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda;School of Public Health, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda;Muhimbili University of Health and Allied Sciences, Dar-es-Salam, Tanzania;Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA

关键词: Sub-Saharan Africa;    Uganda;    Trial protocol;    Randomized double-blind placebo-controlled trial;    Nutrition;    Micronutrient supplementation;    HAART;    HIV infected adults;   

Others  :  1175148
DOI  :  10.1186/1471-2334-12-304

 received in 2012-09-30, accepted in 2012-11-09,  发布年份 2012

【 摘 要 】

Background

Use of multivitamin supplements during the pre-HAART era has been found to reduce viral load, enhance immune response, and generally improve clinical outcomes among HIV-infected adults. However, immune reconstitution is incomplete and significant mortality and opportunistic infections occur in spite of HAART. There is insufficient research information on whether multivitamin supplementation may be beneficial as adjunct therapy for HIV-infected individuals taking HAART. We propose to evaluate the efficacy of a single recommended daily allowance (RDA) of micronutrients (including vitamins B-complex, C, and E) in slowing disease progression among HIV-infected adults receiving HAART in Uganda.

Methods/Design

We are using a randomized, double-blind, placebo-controlled trial study design. Eligible patients are HIV-positive adults aged at least 18 years, and are randomized to receive either a placebo; or multivitamins that include a single RDA of the following vitamins: 1.4 mg B1, 1.4 mg B2, 1.9 mg B6, 2.6 mcg B12, 18 mg niacin, 70 mg C, 10 mg E, and 0.4 mg folic acid. Participants are followed for up to 18 months with evaluations at baseline, 6, 12 and 18 months. The study is primarily powered to examine the effects on immune reconstitution, weight gain, and quality of life. In addition, we will examine the effects on other secondary outcomes including the risks of development of new or recurrent disease progression event, including all-cause mortality; ARV regimen change from first- to second-line therapy; and other adverse events as indicated by incident peripheral neuropathy, severe anemia, or diarrhea.

Discussions

The conduct of this trial provides an opportunity to evaluate the potential benefits of this affordable adjunct therapy (multivitamin supplementation) among HIV-infected adults receiving HAART in a developing country setting.

Trial registration

Clinical Trial Registration-URL:http://www.clinicaltrials.gov webcite. Unique identifier: NCT01228578

【 授权许可】

   
2012 Guwatudde et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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