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 (25th, 75th percentiles) plasma levels of carotenoids for all women in the study were α-carotene, 0.040 (0.23, 0.071) μmol/L; β-carotene, 0.350 (0.192, 0.595) μmol/L; β-cryptoxanthin, 0.050 (0.029, 0.091) μmol/L; lutein/zeaxanthin 0.646 (0.426, 0.976) μmol/L; lycopene, 0.088 (0.055, 0.138) μmol/L, and total carotenoids 1.321 (0.884, 1.874) μmol/L. Mothers had higher mean plasma concentrations of α-carotene (p < 0.04), β-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 β-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.