{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T12:54:55Z","timestamp":1774616095202,"version":"3.50.1"},"reference-count":33,"publisher":"American Society for Microbiology","issue":"3","license":[{"start":{"date-parts":[[2002,5,1]],"date-time":"2002-05-01T00:00:00Z","timestamp":1020211200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Clin Vaccine Immunol"],"published-print":{"date-parts":[[2002,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>In animal studies, vitamin A deficiency induces a shift from type 2 (humoral) to type 1 (cellular) cytokines; there are no similar data for humans. Control of human immunodeficiency virus (HIV) and<jats:italic>Mycobacterium tuberculosis<\/jats:italic>infections requires type 1 cytokine (cellular) immunity. These infections and vitamin A deficiency are highly prevalent in Africa. We therefore examined the interactions among serum vitamin A levels, immune parameters, HIV infection status,<jats:italic>Mycobacterium bovis<\/jats:italic>BCG vaccine scarring (as an indicator of a type 1 cytokine profile), and clinical findings for 70 hospitalized children in Malawi, Africa. Directly conjugated monoclonal antibodies and flow cytometry were used to assess cell-specific cytokine production by peripheral blood monocytes and lymphocyte subpopulations. The statistical techniques employed included nonparametric statistics and logistic regression analyses. Thirty percent of the participants had severe vitamin A deficiency (&lt;10 \u03bcg\/dl), 34% had moderate deficiency (10 to &lt;20 \u03bcg\/dl), and 36% had normal levels (\u226520 \u03bcg\/dl). Vitamin A levels were lower for HIV-positive than for HIV-negative children (median, 10 and 17 \u03bcg\/dl, respectively). Vitamin A-deficient children (&lt;20 \u03bcg\/dl) were more likely than non-vitamin A-deficient children to have higher proportions of natural killer (NK) cells (median, 8.3 and 5.2%, respectively) and lower ratios of interleukin-10-producing monocytes to tumor necrosis factor alpha-producing monocytes after induction (median, 1.0 and 2.3, respectively). Vitamin A-deficient children were also more likely than non-vitamin A-deficient children to exhibit respiratory symptoms (47% versus 12%) and visible BCG vaccine scars (83% versus 48%), which are indicative of a type 1 response to vaccination. Vitamin A status did not vary with gender, age, incidence of malaria parasitemia, blood culture positivity, or rates of mortality (6% of vitamin A-deficient children died versus 20% of non-vitamin A-deficient children). Lower vitamin A levels were associated with a relative type 1 cytokine dominance and proportionately more NK cells, both of which may be somewhat beneficial to persons who are exposed to HIV,<jats:italic>M. tuberculosis<\/jats:italic>, or other type 1 pathogens.<\/jats:p>","DOI":"10.1128\/cdli.9.3.616-621.2002","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T10:09:29Z","timestamp":1027764569000},"page":"616-621","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":6,"title":["Vitamin A Levels and Immunity in Humans"],"prefix":"10.1128","volume":"9","author":[{"given":"Janine","family":"Jason","sequence":"first","affiliation":[{"name":"HIV Immunology and Diagnostics Branch, Division of AIDS, STD, and TB Laboratory Research"},{"name":"Investigation and Prevention Branch, Hospital Infections Program, National Center for Infectious Diseases"},{"name":"Office of Global Health"},{"name":"Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, U.S. Public Health Service, Atlanta, Georgia 30333"},{"name":"Lilongwe Central Hospital and the Community Health Sciences Unit, Ministry of Health and Population, Lilongwe, Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lennox K.","family":"Archibald","sequence":"additional","affiliation":[{"name":"HIV Immunology and Diagnostics Branch, Division of AIDS, STD, and TB Laboratory Research"},{"name":"Investigation and Prevention Branch, Hospital Infections Program, National Center for Infectious Diseases"},{"name":"Office of Global Health"},{"name":"Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, U.S. Public Health Service, Atlanta, Georgia 30333"},{"name":"Lilongwe Central Hospital and the Community Health Sciences Unit, Ministry of Health and Population, Lilongwe, Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Okey C.","family":"Nwanyanwu","sequence":"additional","affiliation":[{"name":"HIV Immunology and Diagnostics Branch, Division of AIDS, STD, and TB Laboratory Research"},{"name":"Investigation and Prevention Branch, Hospital Infections Program, National Center for Infectious Diseases"},{"name":"Office of Global Health"},{"name":"Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, U.S. Public Health Service, Atlanta, Georgia 30333"},{"name":"Lilongwe Central Hospital and the Community Health Sciences Unit, Ministry of Health and Population, Lilongwe, Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne L.","family":"Sowell","sequence":"additional","affiliation":[{"name":"HIV Immunology and Diagnostics Branch, Division of AIDS, STD, and TB Laboratory Research"},{"name":"Investigation and Prevention Branch, Hospital Infections Program, National Center for Infectious Diseases"},{"name":"Office of Global Health"},{"name":"Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, U.S. Public Health Service, Atlanta, Georgia 30333"},{"name":"Lilongwe Central Hospital and the Community Health Sciences Unit, Ministry of Health and Population, Lilongwe, Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Buchanan","sequence":"additional","affiliation":[{"name":"HIV Immunology and Diagnostics Branch, Division of AIDS, STD, and TB Laboratory Research"},{"name":"Investigation and Prevention Branch, Hospital Infections Program, National Center for Infectious Diseases"},{"name":"Office of Global Health"},{"name":"Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, U.S. Public Health Service, Atlanta, Georgia 30333"},{"name":"Lilongwe Central Hospital and the Community Health Sciences Unit, Ministry of Health and Population, Lilongwe, Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua","family":"Larned","sequence":"additional","affiliation":[{"name":"HIV Immunology and Diagnostics Branch, Division of AIDS, STD, and TB Laboratory Research"},{"name":"Investigation and Prevention Branch, Hospital Infections Program, National Center for Infectious Diseases"},{"name":"Office of Global Health"},{"name":"Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, U.S. Public Health Service, Atlanta, Georgia 30333"},{"name":"Lilongwe Central Hospital and the Community 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of AIDS, STD, and TB Laboratory Research"},{"name":"Investigation and Prevention Branch, Hospital Infections Program, National Center for Infectious Diseases"},{"name":"Office of Global Health"},{"name":"Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, U.S. Public Health Service, Atlanta, Georgia 30333"},{"name":"Lilongwe Central Hospital and the Community Health Sciences Unit, Ministry of Health and Population, Lilongwe, Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamish","family":"Dobbie","sequence":"additional","affiliation":[{"name":"HIV Immunology and Diagnostics Branch, Division of AIDS, STD, and TB Laboratory Research"},{"name":"Investigation and Prevention Branch, Hospital Infections Program, National Center for Infectious Diseases"},{"name":"Office of Global Health"},{"name":"Division of Laboratory Sciences, National Center for 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