Carotenoid status of pregnant women with and without HIV infection in Malawi

Objective: To characterise the major plasma carotenoids in pregnant women with and without HIV infection attending antenatal clinic in Blantyre, Malawi, Design: a cross sectional study. Setting: Antenatal clinic of Queen Elizabeth Central Hospital, Blantyre, Malawi. Subjects: Nine hundred women (697 HIV-positive and 203 HIV-negative women) in their second trimester of pregancy, Main outcome measures: Plasma carotenoid levels as related to HIV status and level of disease progression. Results: There were no significant differences in plasma carotenoid levels between HIV-positive and HIV-negative women. Median (25(th), 75(th) percentiles) plasma levels of carotenoids for all women in the study were alpha-carotene, 0.040 (0.23, 0.071) mu mol/L; beta-carotene, 0.350 (0.192, 0.595) mu mol/L; beta-cryptoxanthin, 0.050 (0.029, 0.091) mu mol/L; lutein/zeaxanthin 0.646 (0.426, 0.976) mu mol/L; lycopene, 0.088 (0.055, 0.138) mu mol/L, and total carotenoids 1.321 (0.884, 1.874) mu mol/L. Mothers had higher mean plasma concentrations of alpha-carotene (p<0.04), beta-carotene (p<0.0001), lutein/zeaxanthin (p<0.0001), and total carotenoids (p<0.0001) in the wet season than the dry season. No seasonality was observed for beta-cryptoxanthin, lycopene, or retinol, Conclusion: This study suggests that pregnant women with and without HIV infection in Blantyre, Malawi have relatively low plasma carotenoid levels and poor dietary intake of provitamin A carotenoids.