Micronutrient status during lactation in HIV-infected and HIV-uninfected South African women during the first 6 mo after delivery

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Abstract
Background: Little information on the micronutrient status of HIV-infected (HIV-positive) breastfeeding women is available. Objective: The objective was to compare the protein and micronutrient status of South African breastfeeding women by HIV status. Design: Serum albumin, prealbumin, vitamin B-12, folate, retinol, α-tocopherol, hemoglobin, ferritin, and zinc concentrations were compared between 92 HIV-positive and 52 HIV-uninfected (HIV-negative) mothers 6, 14, and 24 wk after delivery. C-reactive protein and α1-acid glycoprotein were used as proxy indicators of an inflammatory process. Results: Mean albumin and prealbumin were significantly lower in HIV-positive mothers, and a higher proportion of HIV-positive mothers had low albumin concentrations (P < 0.05), and mean folate concentrations were lower in HIV-positive mothers (P = 0.05). Mean serum retinol was significantly lower in HIV-positive mothers, even after control for the acute phase response. At 24 wk, 70% of both groups had an α-tocopherol deficiency (P = 0.018), whereas 25% of all mothers had low serum ferritin concentrations. After the acute phase response was controlled for, zinc deficiency was more common in HIV-positive (45.0%) than in HIV-negative (25.0%) mothers (P = 0.05). Conclusions: Deficiencies in vitamins B-12, folate, α-tocopherol, ferritin, and zinc are common in South African breastfeeding mothers. HIV-positive mothers had lower mean serum concentrations of albumin, prealbumin, folate, retinol, and hemoglobin than did HIV-negative mothers.