Micronutrient deficiencies may increase the risk of adverse pregnancy outcomes among HIV-infected women via a number of biological mechanisms. For example, sub-optimal micronutrient status may increase the risk of mother-to-child transmission
(MTCT) of HIV by impairing systemic immune function and by affecting the epithelial integrity of the maternal lower genital tract [27, 28]. Deficiencies of various micro-nutrients may amplify the risk of postpartum HIV transmission by increasing the risk of clinical or subclinical mastitis and subsequent viral shedding, and by impairing the epithelial integrity of the infant gastrointestinal tract [27, 29]. Micronutrient deficiencies may also accelerate clinical, immunologic, and virologic HIV disease progression, and consequently increase maternal morbidity and risk of HIV transmission [3, 27]. Further, HIV infection itself may affect nutrient absorption and contribute to the development of micronutrient deficiencies and wasting, thus perpetuating a vicious cycle .
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