{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T07:18:10Z","timestamp":1761895090734},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2010,6,3]],"date-time":"2010-06-03T00:00:00Z","timestamp":1275523200000},"content-version":"vor","delay-in-days":153,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of the International AIDS Society"],"published-print":{"date-parts":[[2010,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Micronutrient deficiencies compromise the survival of HIV\u2010infected children in low\u2010income countries. We assessed the effect of multiple micronutrient supplementation on the mortality of HIV\u2010infected children in Uganda.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a randomized, controlled trial, 847 children aged one to five years and attending HIV clinics in Uganda were stratified by antiretroviral therapy (ART, n = 85 versus no ART, n = 762). The children were randomized to six months of either: twice the recommended dietary allowance of 14 micronutrients as the intervention arm (vitamins A, B<jats:sub>1<\/jats:sub>, B<jats:sub>2<\/jats:sub>, niacin, B<jats:sub>6<\/jats:sub>, B<jats:sub>12<\/jats:sub>, C, D and E, folate, zinc, copper, iodine and selenium); or the standard recommended dietary allowance of six multivitamins (vitamins A, D<jats:sub>2,<\/jats:sub> B<jats:sub>1<\/jats:sub>, B<jats:sub>2<\/jats:sub>, C and niacin) as a comparative \u201cstandard\u2010of\u2010care\u201d arm. Mortality was analyzed at 12 months of follow up using Kaplan Meier curves and the log rank test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mortality at 12 months was 25 out of 426 (5.9%) children in the intervention arm and 28 out of 421 (6.7%) in the comparative arms: risk ratio 0.9 (95% CI 0.5 \u2010 1.5). Two out of 85 (2.4%) children in the ART stratum died compared with 51 out of 762 (6.7%) in the non\u2010ART stratum. Of those who died in the non\u2010ART stratum, 25 of 383 (6.5%) were in the intervention arm and 26 of 379 (6.9%) in the comparative arm; risk ratio 1.0 (95% CI 0.6 \u2010 1.6). There was no significant difference in survival at 12 months (p = 0.64, log rank test). In addition, there was no significant difference in mean weight\u2010for\u2010height at 12 months; 0.70 \u00b1 1.43 (95% CI 0.52 \u2010 0.88) for the intervention versus 0.59 \u00b1 1.15 (95% CI 0.45 \u2010 0.75) in the comparative arm. The mean CD4 cell count; 1024 \u00b1 592 (95% CI 942 \u2010 1107) versus 1060 \u00b1 553 (95% CI 985 \u2010 1136) was also similar between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Twice the recommended dietary allowance of 14 micronutrients compared with a standard recommended dietary allowance of six multivitamins for six months was well tolerated, but it did not significantly alter mortality, growth or CD4 counts. Future intervention studies should carefully consider: (1) the composition and dosing of the supplements; and (2) the power needed to detect a difference between arms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p>ClinicalTrials.gov Identifier: NCT00122941<\/jats:p><\/jats:sec>","DOI":"10.1186\/1758-2652-13-18","type":"journal-article","created":{"date-parts":[[2010,6,3]],"date-time":"2010-06-03T18:13:47Z","timestamp":1275588827000},"page":"18-18","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Effect of multiple micronutrient supplementation on survival of HIV\u2010infected children in Uganda: a randomized, controlled 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