Vitamin A supplementation in HIV-infected infants and children 6–59 months of age
Vitamin A deficiency affects about 190 million preschool-age children, mostly from Africa and South-East Asia. In infants and children, vitamin A is essential to support rapid growth and to help combat infections. Inadequate intakes of vitamin A may lead to vitamin A deficiency which can cause visual impairment in the form of night blindness, may increase the risk of illness and death from childhood infections, and may compound the effects of HIV infection.
Research has shown that vitamin A supplementation in HIV-infected infants and children is safe and effective in reducing illness and death. Vitamin A can be safely provided to children in a large dose, rather than more frequent smaller doses, as it can be stored by the body and released over time as needed.
Many countries have successfully integrated strategies to deliver vitamin A supplements to infants and children in their national health policies, including delivery during routine health visits and immunizations.
In settings where vitamin A deficiency is a public health problem (prevalence of night blindness is 1% or higher in children 24–59 months of age or where the prevalence of vitamin A deficiency (serum retinol 0.70 µmol/l or lower) is 20% or higher in infants and children 6–59 months of age), high-dose vitamin A supplementation is recommended in infants and children 6–59 months of age.
The above recommendation can also be applied in populations where infants and children may be infected with HIV.
Determination of vitamin A deficiency as a public health problem involves estimating the prevalence of deficiency in a population by using specific biochemical and clinical indicators of vitamin A status. Classification of countries based on the most recent estimates is available in the guidance document, Global prevalence of vitamin A deficiency in populations at risk 1995–2005, under 'WHO documents' below.
A suggested scheme for vitamin A supplementation in infants and children 6–59 months of age can be found in the guideline, Vitamin A supplementation for infants and children 6-59 months of age, under 'WHO documents' below.
Other guidance documents
Global prevalence of vitamin A deficiency in populations at risk 1995-2005: WHO Global Database on Vitamin A Deficiency
Systematic reviews used to develop the guidelines
- Micronutrient supplementation in children and adults with HIV infection
- Vitamin A supplementation for preventing morbidity and mortality in children from 6 months to 5 years of age