Effects of Vitamin A Supplementation on Immune Responses and Correlation with Clinical Outcomes
SUMMARY
INTRODUCTION
VITAMIN A SUPPLEMENTATION AND INNATE IMMUNE RESPONSES
Barrier Function and Mucosal Immunity
Acute-Phase Response and Complement System
Monocytes/Macrophages
Natural Killer Cells and Neutrophils
VITAMIN A SUPPLEMENTATION AND ADAPTIVE IMMUNE RESPONSES
T and B Lymphocytes
T-cell counts.
T-cell function.
B cells.
T-Cell-Dependent Humoral Responses
Tetanus and diphtheria.
Measles.
Polio.
Influenza.
T-Cell-Independent Humoral Responses
VITAMIN A SUPPLEMENTATION AND CLINICAL OUTCOMES
CONCLUSIONS
Study site (reference[s]) | Intervention groups | Population | End pointa | Result for the indicated measure of effectb | P value | ||||
---|---|---|---|---|---|---|---|---|---|
Vitamin A | Placebo | ||||||||
India (147) | Vitamin A (200,000 IU) on admission vs 200,000 IU at discharge, vs placebo, single dose | 94 infants hospitalized, with diarrhea or respiratory infection | Lactulose/mannitol ratio at 10 and 30 days after discharge | Significantly different in both vitamin A-treated groups compared to control group
|
<0.05 | ||||
Vitamin A (16,700 IU) weekly for 8 wk vs placebo | 80 infants | Lactulose/mannitol ratio at 4 and 8 wk | No difference at any time point
|
||||||
South Africa (49, 115) | Vitamin A (5,000 IU) + β-carotene (30 mg) daily during pregnancy + vitamin A (200,000 IU) at delivery to mothers vs placebo | 238 infants born to 728 HIV+ women | Lactulose/mannitol ratio: | Vitamin A | Placebo | ||||
Among HIV− infants at 14 weeks | 0.11 | 0.09 | >0.05 | ||||||
Among HIV+ infants at 14 weeks | 0.17 | 0.50 | <0.05 | ||||||
Lactulose/creatinine ratio at: | |||||||||
1 wk | Lower | Higher | 0.009 | ||||||
14 wk | Lower | Higher | 0.014 | ||||||
242 infants | Urinary neopterin excretion in infants at 0, 1 wk, 6 wk, 6 mo | No significant effect
|
|||||||
Malawi (128) | Vitamin A (10,000 IU) daily during pregnancy vs placebo | 334 HIV+ pregnant women | Breast milk lactoferrin at 6 wk postpartum | Vitamin A | Placebo | ||||
No effect
|
|||||||||
Bangladesh (48) | Vitamin A (200,000 IU) single dose vs 7.6 mg β-carotene daily vs placebo started at 1-3 wk postpartum for 9 mo | 212 postpartum women | Breast milk immune factors at 3 mo from first dose | Vitamin A | β-Carotene | Placebo | |||
Secretory IgA (g/liter) | 0.74 | 0.79 | 0.86 | >0.05 | |||||
Lactoferrin (g/liter) | 3.06 | 3.04 | 3.40 | >0.05 | |||||
Lysozyme (mg/liter) | 118 | 124 | 109 | >0.05 | |||||
IL-8 (ng/liter) | 29.6 | 26.2 | 33.6 | >0.05 | |||||
South Africa (102) | Vitamin A (5,000 IU) + β-carotene (30 mg) daily during pregnancy + vitamin A (200,000 IU) at delivery vs placebo | 60 HIV+ pregnant women | Immune factors in CVL | Vitamin A | Placebo | ||||
Lactoferrin after 6 wk | No effect
|
||||||||
Lysozyme after 6 wk | No effect
|
||||||||
SLPI after 6 wk | No effect
|
||||||||
Mexico (82) | Vitamin A (45,000 IU, or 20,000 IU if <12 mo) vs placebo every 2 mo for 1 yr | 188 infants, 6-15 mo | Cytokines in stool | Vitamin A | Placebo | ||||
IL-4 | No significant effect
|
>0.05 | |||||||
IL-5 | No effect
|
||||||||
IL-6 | Higher during summer in vitamin A group
|
<0.05 | |||||||
Lower after enterotoxigenic E. coli
|
<0.05 | ||||||||
IL-8 | Lower after enterotoxigenic E. coli
|
<0.05 | |||||||
IL-10 | No effect
|
||||||||
TNF-α | Higher during summer in vitamin A group
|
<0.05 | |||||||
IFN-γ | No effect
|
||||||||
MCP-1 | No significant effect
|
>0.05 | |||||||
Ghana (47) | Vitamin A (200,000 IU, or 100,000 IU if < 12 mo) vs placebo every 4 mo for 1 yr | 329 children age 6-59 mo | Ratio of acute-phase proteins between vitamin A and placebo groups | Vitamin A | Placebo | ||||
Serum amyloid A | |||||||||
Children with vomiting | 2.15
|
>0.05 | |||||||
Children with diarrhea | 4.20
|
<0.05 | |||||||
C-reactive protein | |||||||||
Children with vomiting | 2.91
|
<0.05 | |||||||
Children with diarrhea | 2.11
|
>0.05 | |||||||
α1-Glycoprotein | |||||||||
Children with vomiting | 1.15
|
>0.05 | |||||||
Children with diarrhea | 1.18
|
>0.05 | |||||||
Indonesia (120) | Vitamin A (200,000 IU) vs placebo, single dose, 2 wk before antitetanus immunization | 236 children age 3-6 yr, 50% xerophtalmic | Change from baseline at 5 wk | Vitamin A | Placebo | ||||
α1-Glycoprotein | No significant differences
|
||||||||
C-reactive protein | No significant differences
|
||||||||
South Africa (28) | Vitamin A (200,000 IU, or 100,000 IU if <12 mo) vs placebo at days 0, 2, 8, and 42 | 60 infants age 4-24 mo hospitalized with measles | Plasma complement C3 (g/liter) at days | Vitamin A | Placebo | ||||
8 | 1.25 | 1.11 | >0.05 | ||||||
42 | 1.48 | 1.41 | >0.05 |
Study site (reference[s]) | Intervention groups | Population | End point | Result for the indicated measure of effectb | P value | ||
---|---|---|---|---|---|---|---|
South Africa (28) | Vitamin A (200,000 IU, or 100,000 IU if <12 mo) vs placebo on days 0, 2, 8, and 42 | 60 infants age 4-24 mo hospitalized with measles | Lymphocyte count (109/liter) Difference at day 42 Change from day 0 to day 42 IL-2 (IU/ml) at day: 8 42 | Vitamin A 8.10 3.40 1.76 1.74 | Placebo 6.45 1.96 1.72 1.70 | 0.05 0.06 >0.05 >0.05 | |
Indonesia (132) | Vitamin A (200,000 IU) vs placebo, | 55 children age | CD4/CD8 ratio at 5 wk from | Vitamin A | Placebo | ||
single dose, 2 wk before antitetanus | 3-6 yr. 30 | supplementation | 1.32 | 0.97 | <0.0001 | ||
immunization | xerophthalmic | % CD4 naive T cells at 5 wk | Higher in vitamin A group
|
<0.01 | |||
Change in T-cell subsets after 5 wk | |||||||
CD4/CD8 ratio | Significant increase, P < 0.007 | No significant change | |||||
% CD4+ CD45RA+ | Significant increase, P < 0.003 | No significant change | |||||
% CD4+ CD45RO+ | No change in any group, no significant difference in change
|
||||||
% CD8+ CD45RA+ | No change in any group, no significant difference in change
|
||||||
% CD8+ CD45RO+ | Significant decrease | No significant change | |||||
Guinea-Bissau (13) | Vitamin A (100,000 IU) at age 6 mo vs placebo | 276 infants | T-cell subset change between 6 and 9 mo of age | Vitamin A | No vitamin A | ||
% CD4 | −0.11 | 0.45 | 0.31 | ||||
% CD8 | 1.21 | 1.61 | 0.21 | ||||
CD4/CD8 ratio | −0.15 | −0.07 | 0.26 | ||||
Vitamin A (100,000 IU) at age 6 and 9 mo vs placebo | 185 infants | T-cell subset change at 18 mo | Vitamin A | No vitamin A | |||
% CD4 | 2.50 | −2.72 | 0.07 | ||||
% CD8 | −1.93 | 0.49 | 0.12 | ||||
CD4/CD8 ratio | 0.28 | −0.20 | 0.06 | ||||
South Africa (66) | Vitamin A (200,000 IU) on 2 consecutive days vs placebo | 75 HIV+ infants | Absolute lymphocyte count at 4 wk | Vitamin A | Placebo | ||
Increase
|
0.05 | ||||||
CD4 cell count at 4 wk | Increase
|
0.03 | |||||
CD56 cell count at 4 wk | Increase
|
0.05 | |||||
CD29 cell count at 4 wk | Increase
|
0.07 | |||||
Vitamin A | Placebo | ||||||
South Africa (76) | Vitamin A (5,000 IU)+ β-carotene (30 mg) daily during pregnancy + vitamin A (200,000 IU) at delivery to mothers vs placebo | 33 infants born to 728 HIV+ women | T-helper cell responses to HIV in cord blood (infants) | Slightly more frequent in vitamin A arm but not significant
|
|||
Tanzania (40, 44-46) | Vitamin A (5,000 IU) +β -carotene (30 mg) daily during | 1,078 HIV+ | Woman's T-cell subset counts (/μl) | Vitamin A | Placebo | ||
pregnancy and breast feeding to mothers vs placebo | pregnant women | CD4 at 6 wk postpartum | 558 | 562 | 0.13 | ||
CD4 at 30 wk postpartum | 496 | 509 | 0.23 | ||||
Overall effect | 0.29 | ||||||
CD8 at 6 wk postpartum | 1,061 | 1,094 | 0.32 | ||||
CD8 at 30 wk postpartum | 943 | 909 | 0.26 | ||||
Overall effect | 0.13 | ||||||
CD3 at 6 wk postpartum | 1,698 | 1,741 | 0.20 | ||||
CD3 at 30 wk postpartum | 1,515 | 1,494 | 0.68 | ||||
Overall effect | 0.25 | ||||||
393 HIV+ pregnant women | IL-1β in CVL (μg/ml) | 218c | 219c | 0.41 | |||
664 infants born to 1,078 HIV+ women | Infant's CD4 cell count during first 2 yr | No effect
|
|||||
Vitamin A (5,000 IU)+ β-carotene (30 mg) daily for ≈3-5 yr | 1,078 HIV+ women | T-cell subsets (/μl) at >4 yr after enrollment | |||||
CD4 | 434 | 449 | 0.30 | ||||
CD8 | 920 | 968 | 0.07 | ||||
CD3 | 1,425 | 1,497 | 0.05 | ||||
United States (129) | Vitamin A (200,000 IU) single dose vs placebo | 120 HIV+ | Vitamin A | Placebo | |||
injection drug users | CD4 cells (/μl) at 4 wk | 0.17 | |||||
United States (65) | Vitamin A (300,000 IU) single dose vs placebo | 40 HIV+ women | Vitamin A | Placebo | |||
% CD4 at 8 wk | 0.56 | ||||||
% CD8 that are CD38+ | >0.05 | ||||||
Lymphocyte proliferation in response to: | |||||||
PHA | >0.05 | ||||||
Candida | >0.05 | ||||||
Kenya (5) | Vitamin A (10,000 IU) daily for 6 wk vs placebo | 400 HIV+ women | T-cell subsets at 6 wk (/μl) | Vitamin A | Placebo | ||
CD4 | 272 | 225 | 0.04 | ||||
CD8 | 719 | 581 | 0.08 | ||||
Italy (50) | Vitamin A (≈1,500 IU) daily for 3 mo vs. placebo, in both | 118 men and | Total leucocytes (/μl) | Vitamin A | No Vitamin A | ||
groups, half also received 25 mg zinc zulfate | women age >65 | Baseline | 6,149 | 6,206 | |||
Change from baseline | 138 | 361 | 0.30 | ||||
Lymphocytes (/μl) | |||||||
Baseline | 1,977 | 1,942 | |||||
Change from baseline | −73 | 62 | 0.05 | ||||
CD3+ (/μl) | |||||||
Baseline | 1,260 | 1,123 | |||||
Change from baseline | −109 | 49 | 0.01 | ||||
CD4+ (/μl) | |||||||
Baseline | 712 | 711 | |||||
Change from baseline | −125 | −23 | 0.01 | ||||
CD4+ DR+ (/μl) | |||||||
Baseline | 76 | 70 | |||||
Change from baseline | 6 | 18 | 0.12 | ||||
CD8+ (/μl) | |||||||
Baseline | 665 | 629 | |||||
Change from baseline | −70 | 30 | 0.12 | ||||
CD8+ DR+ (μl) | |||||||
Baseline | 139 | 116 | |||||
Change from baseline | −0.8 | −0.7 | 0.64 | ||||
CD4/CD8 ratio | |||||||
Baseline | 1.17 | 1.16 | |||||
Change from baseline | −0.10 | −0.05 | 0.55 | ||||
Cytotoxic T lymphocytes | |||||||
Baseline | 70 | 84 | |||||
Change from baseline | 23 | 51 | 0.19 | ||||
NK cells (/μl) | |||||||
Baseline | 225 | 252 | |||||
Change from baseline | −4 | 45 | 0.11 | ||||
Vitamin A | Control | ||||||
Bangladesh (20) | Vitamin A (200,000 IU intramuscularly) vs no intervention at the time of first of 3 antitetanus immunizations | 91 children 1-6 yr | % of positive cutaneous DTH responses (≥5 mm) to a protein derivative and Candida after 4 wk | 29.5 | 31.9 | >0.05 | |
Zambia (116) | Vitamin A (200,000 IU) single dose vs placebo | 200 children age | Cutaneous DTH response at 2 wk | Vitamin A | Placebo | ||
5 mo-17 yr | % Children with reactions | 44.4 | 61.3 | 0.04 | |||
hospitalized | Sum of indurations ≥2 mm | 6.9 | 8.4 | 0.20 | |||
with measles | Mean induration per reaction | 4.1 | 3.9 | 0.50 | |||
% of children unresponsive to specific antigens | |||||||
Tetanus | 82.8 | 81.0 | >0.05 | ||||
Diphtheria | 81.8 | 82.5 | >0.05 | ||||
Tuberculin (PPD) | 86.6 | 72.1 | <0.05 | ||||
Streptococcus | 100.0 | 90.1 | >0.05 | ||||
Candida | 97.1 | 85.5 | <0.05 | ||||
Trichophyton | 97.1 | 92.8 | >0.05 | ||||
Proteus | 97.1 | 86.8 | <0.05 | ||||
IL-4, % change from baseline to 2 wk | 9.0 | 35.0 | 0.18 | ||||
Bangladesh (106) | Vitamin A (50,000 IU) vs placebo at each time of DPT/OPV vaccination (0, 4, and 8 wk) | 120 infants age 6-17 wk | Cutaneous DTH response (% children) after 1 mo after last dose | Vitamin A | Placebo | ||
Tetanus | 30.6 | 32.8 | >0.05 | ||||
Diphtheria | 30.6 | 22.4 | >0.05 | ||||
Tuberculin (PPD) | 59.7 | 46.6 | >0.05 | ||||
Streptococcus | 4.8 | 6.9 | >0.05 | ||||
Candida | 3.2 | 8.6 | >0.05 | ||||
Trichophyton | 1.6 | 3.4 | >0.05 | ||||
Proteus | 4.8 | 1.7 | >0.05 | ||||
Total (sum induration) | 72.6 | 67.2 | >0.05 | ||||
Total among children with baseline retinol ≥0.7 μmol/liter | 93.3 | 57.9 | 0.008 | ||||
Avg induration (mm) among children with baseline retinol ≥0.7 μmol/liter | 7.0 | 4.2 | 0.01 | ||||
% Anergic infants | 27.4 | 32.8 | >0.05 |
Study site (reference[s]) | Intervention groups | Population | End point | Result for the indicated measure of effectb | P value | ||||
---|---|---|---|---|---|---|---|---|---|
Bangladesh (20) | Vitamin A (200,000 IU intramuscularly) vs no intervention at the time of first of 3 anti tetanus immunizations | 95 children 1-6 yr | Anti-tetanus GMT IgG (IU/ml) at 12 wk from first immunization (8 from second immunization) | Vitamin A | Control | ||||
0.016 | 0.011 | >0.05 | |||||||
Indonesia (131) | Vitamin A (200,000 IU) vs placebo, single dose, 2 wk before antitetanus immunizations | 236 children age 3-6 yr, 50% xerophtalmic | Anti-tetanus GM IgG (μg/liter) change after 3 wk from immunization in: | Vitamin A | Placebo | ||||
Tetanus-naive childrenc | 62 | 24 | <0.009 | ||||||
Tetanus-exposed childrenc | 1,903 | 891 | <0.07 | ||||||
Turkey (79) | Vitamin A (30,000 IU) for 3 days | 89 infants | Anti-tetanus GMT IgG (mIU/ml) at age: | Vitamin A only | Placebo only | ||||
together with DPT at 2, 3, and 4 mo | 5 mo | 1,126.6 | 880.6 | >0.05 | |||||
of age (half also received 150 mg | 16-18 mo | 314.7 | 314.4 | >0.05 | |||||
vitamin E one dose at each time | Protective antitetanus titers (≥100 mIU/ml) at age: | ||||||||
5 mo | 100% | 100% | >0.05 | ||||||
16-18 mo | 92% | 92% | >0.05 | ||||||
Bangladesh (108) | Vitamin A (50,000 IU) vs placebo at each time of DPT/OPV vaccination | 56 infants | GM IgG (mg/liter) after 1 mo from last dose | Vitamin A | Placebo | ||||
(0, 4, and 8 wk) | Antidiphteria | 22.9 | 11.0 | 0.029 | |||||
Antipertussis | 4.1 | 5.7 | >0.05 | ||||||
Antitetanus | 112 | 119 | >0.05 | ||||||
South Africa (28) | Vitamin A (200,000 IU, or 100,000 IU if <12 mo) vs placebo at days 0, 2, 8, | 60 infants age 4-24 mo | IgG anti-measles nucleocapsid protein (mIU/ml) at day: | Vitamin A | Placebo | ||||
and 42 | hospitalized | 8 | 384.2 | 222.8 | 0.01 | ||||
with measles | 42 | 869.5 | 654.8 | >0.05 | |||||
Zambia (116) | Vitamin A (200,000 IU) single dose vs placebo | 200 children age 5 mo-17 yr hospitalized with measles | GMT IgG anti-measles hemagglutinin protein at 2 wk from vitamin A dose | Vitamin A 4.12 | Placebo 4.30 | 0.25 | |||
Indonesia (133) | Vitamin A (100,000 IU) vs placebo at the time of measles immunization (age 6 mo), single dose | 336 infants age 6 mo | Seroconversion to measlesd after 6 mo from immunization among infants with titer of: | Vitamin A | Placebo | ||||
≥8 | 66.3% | 79.3% | <0.04 | ||||||
<8 | 100.0% | 100.0% | - | ||||||
Protective titers (>120) after 6 mo in infants with baseline titers≥ 8 | 61.8% | 77.2% | <0.03 | ||||||
GMT to measles vaccine after: | |||||||||
1 mo | 25% lower in vitamin A group
|
0.05 | |||||||
6 mo | 25% lower in vitamin A group
|
0.09 | |||||||
Guinea-Bissau (10, 11, 14) | Vitamin A (100,000 IU) vs placebo at 2 times of measles immunization (ages 6 and 9 mo) | 150 infants age 6 mo | Seroconversion to measlese | Vitamin A | Placebo | ||||
At age 9 mo | |||||||||
Baseline titer ≥32 mlU | 20% | 20% | >0.05 | ||||||
Baseline titer <32 mlU | 88% | 79% | >0.05 | ||||||
Overall | 74% | 65% | >0.05 | ||||||
At age 18 mo | 98% | 98% | >0.05 | ||||||
GMT at age 18 mo | 1,431 | 1,768 | >0.05 | ||||||
79 infants followed up | Protective titers (≥125 mIU/liter) at age 6-8 yr | 95% | 100% | 0.36 | |||||
GMT at age 6-8 yr | 670 | 783 | 0.51 | ||||||
Vitamin A (100,000 IU) vs placebo at the time of measles immunization (age 9 mo only), single dose | 312 infants age 9 mo | Seroconversion to measlese at age 18 mo | 97% | 93% | 0.15f | ||||
GMT at age 18 mo | 3704 | 2439 | <0.01 | ||||||
152 infants followed up | Protective titers (≥125 mlU/liter) at age 6-8 yr | 100% | 91% | 0.0095 | |||||
GMT at age 6-8 yr | 1,366 | 1,048 | 0.09 | ||||||
India (17) | Vitamin A (100,000 IU) vs placebo at the time of measles immunization (9 mo), single dose | 100 infants | Seroconversion to measlesg after 4 wk | Vitamin A | Placebo | ||||
Among infants with titers≥ 8 | 83.7% | 63.0% | <0.01h | ||||||
Among infants with titers<8 | 100.0% | 75.0% | >0.05 | ||||||
Overall | 84.0% | 64.0% | <0.001h | ||||||
Indonesia (124) | Vitamin A (100,000 IU) vs placebo at the time of measles immunization (age 9 mo)e single dose | 394 infants age 9 mo | Seroconversion to measlesd after 1 mo from immunization | Vitamin A | Placebo | ||||
Baseline titer<8 | 98.5% | 99.0% | >0.05 | ||||||
Baseline titer 8-120 | 100.0% | 100.0% | >0.05 | ||||||
Baseline titer> 120 | 9.5% | 9.1% | >0.05 | ||||||
Protective titer (>120) after 6 mo | |||||||||
Baseline titer<8 | 99.4% | 98.7% | >0.05 | ||||||
Baseline titer 8-120 | 100.0% | 100.0% | >0.05 | ||||||
Baseline titer> 120 | 100.0% | 100.0% | >0.05 | ||||||
GMT to measles vaccine after: | |||||||||
1 mo | 1,772 | 2,298 | 0.18 | ||||||
6 mo | 1,164 | 1,900 | 0.03 | ||||||
Vitamin A | Placebo | ||||||||
India (7) | Vitamin A (100,000 IU) vs placebo at the time of measles immunization (9 mo), single dose | 618 infants | Seroconversion to measlesd 12 wk postimmunization among infants with titers≤ 2,500 | 89.5% | 87.6% | 0.50f | |||
GMT 12 wk postimmunization | 211.8 | 178.2 | >0.05 | ||||||
GMT change from baseline to 12 wk postimmunization | 116.4 | 95.3 | >0.05 | ||||||
GMT 12 wk postimmunization among children with low weight | 251.2 | 160.3 | <0.05 | ||||||
Vitamin A | Placebo | ||||||||
India (23) | Vitamin A (100,000 IU) vs placebo at the time of measles immunization (9-12 mo), single dose | 395 infants | Seroconversion to measlesi 1 mo postimmunization | 99% | 99% | 1.00 | |||
Protective titers (>120) after 6 mo | 78% | 85% | 0.14 | ||||||
GMT to measles vaccine after: | |||||||||
1 month | 169.6 | 160.7 | 0.57 | ||||||
6 months | 187.4 | 212.8 | 0.31 | ||||||
Vitamin A | Placebo | ||||||||
India (23) | Vitamin A (100,000 IU) vs placebo at the time of measles immunization (9-12 mo), single dose | 395 infants | Seroconversion to measlesi 1 mo postimmunization | 99% | 99% | 1.00 | |||
Protective titers (>120) after 6 mo | 78% | 85% | 0.14 | ||||||
GMT to measles vaccine after: | |||||||||
1 month | 169.6 | 160.7 | 0.57 | ||||||
6 months | 187.4 | 212.8 | 0.31 | ||||||
Bangladesh (107) | Vitamin A (50,000 IU) vs placebo at each time of DPT/OPV vaccination | 57 infants | Seroconversion to OPVj after 1 mo from last dose | Vitamin A | Placebo | ||||
(0, 4, and 8 wk) | Type 1 | 79% | 83% | 0.76 | |||||
Type 2 | 82% | 91% | 0.34 | ||||||
Type 3 | 82% | 87% | 0.64 | ||||||
India (15) | Vitamin A (200,000 IU) vs placebo to | 100 mother- | Seroconversion to OPVd at 6 wk | Vitamin A | Placebo | ||||
mothers within 24 h of delivery; all | infant pairs | Type 1 | 67.3% | 77.5% | >0.05 | ||||
newborns received OPV dose within | Type 2 | 83.6% | 79.6% | >0.05 | |||||
72 h of birth | Type 3 | 63.3% | 65.3% | >0.05 | |||||
GMT against poliovirus at 6 wk | |||||||||
Type 1 | 18.4 | 23.4 | >0.05 | ||||||
Type 2 | 17.9 | 21.6 | >0.05 | ||||||
Type 3 | 9.6 | 9.7 | >0.05 | ||||||
Indonesia (130) | Vitamin A (50,000 IU) vs vitamin A (25,000 IU) vs placebo at each time | 467 infants | Seroconversion to OPVk at age 9 mo | Vitamin A, 50,000 IU | Vitamin A, 25,000 IU | Placebo | |||
of OPV vaccination (6, 10, and 14 | Type 1 | 98.0% | 99.1% | 98.9% | 0.77 | ||||
wk) | Type 2 | 100.0% | 100.0% | 100.0% | 1.00 | ||||
Type 3 | 100.0% | 100.0% | 99.1% | 0.99 | |||||
Protective titer (≥8) against poliovirus | |||||||||
Type 1 | 93.1% | 94.5% | 94.5% | 0.88 | |||||
Type 2 | 98.3% | 98.4% | 99.1% | 0.84 | |||||
Type 3 | 96.5% | 98.3% | 95.6% | 0.45 | |||||
Loge antibody titers against poliovirus at age 9 mo | |||||||||
Type 1 | 5.32 | 5.63 | 5.26 | >0.05 | |||||
Type 2 | 5.96 | 6.02 | 5.95 | >0.05 | |||||
Type 3 | 5.21 | 5.44 | 5.36 | >0.05 | |||||
India (6) | Vitamin A (200,000 IL) to mothers between 18 and 28 days postpartum | 399 mother-infant pairs | Protective titer (≥4) against poliovirus after 12 wk from last dose | Vitamin A | Placebo | ||||
plus 25,000 IU to infants at the time | Type 1 | 82.0% | 71.2% | 0.01f | |||||
of DPT/OPVI (6, 10, 14 wks) vs | Type 2 | 92.3% | 93.2% | 0.73f | |||||
placebo to mothers and children | Type 3 | 84.5% | 80.5% | 0.29f | |||||
GMT against poliovirus | |||||||||
Type 1 | 27.2 | 17.6 | <0.05 | ||||||
Type 2 | 287.1 | 289.1 | >0.05 | ||||||
Type 3 | 66.5 | 60.5 | >0.05 | ||||||
United States (57) | Vitamin A (200,000 IU) vs placebo on days 0 and 1; all received inactivated | 59 HIV+ children 2-17 | Increase in influenza antibodies, GMT (U/liter) day 28 | Vitamin A | Placebo | ||||
influenza vaccine and hemagglutinin | yr | H1N1 | 19.8 | 18.9 | 0.68 | ||||
antigens on day 14 | H3N2 | 28.8 | 36.4 | 0.71 | |||||
% with titers ≥1:32 after vaccination | |||||||||
H1N1 | 66 | 50 | 0.23 | ||||||
H3N2 | 66 | 70 | 0.71 |
Acknowledgments
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