Vitamin A is essential for immunity, proper wound healing, vision, regulation of cell development, and the health of the skin and the mucous membranes that line the gastrointestinal tract and lungs.

The carotenoids are the nutrient pigments that give certain plants their yellow yellow, orange, or red color. There are over 600 known carotenoids. Because of its relationship to Vitamin A, beta-carotene is the most well known, but the other carotenes are at least equally important to health.

All of the carotenoid nutrients, including alpha-carotene, beta-carotene, lycopene and the xanthophylls, are very powerful antioxidants, making optimal body levels of obvious importance to those with HIV - a disease known to cause high levels of oxidative stress.

Beta-carotene may also provide protection against two cancers of growing concern: anal and cervical cancer. Beta-carotene has been shown to be deficient in HIV-negative women with cervical dysplasia - the abnormal changes in cells that precede the development of cervical cancer. Supplementation with beta-carotene may have a protective effect against cervical dysplasia. Because the cells lining the anal area are similar to those lining the vaginal area, it is also possible that supplementation with carotenoids might provide protection against anal dysplasia, important since both men and women have been shown to be at increased risk of developing anal cancer.

Deficiencies of Vitamin A can cause dry eyes, night blindness (in conjunction with zinc deficiency), reductions in both white and red blood cells, seriously impaired resistance to infection, dry skin that can cause cracking on the heels, and small, relatively colorless bumps on the arms. The cracked heels can be quite painful and leave an opening for infection.

For PWHIV: Normally, an enzyme converts beta-carotene to Vitamin A whenever the body needs it. However, most of the conversion of beta-carotene to Vitamin A occurs in the mucosal lining of the gut (some also occurs in the liver). In people living with HIV, there is often significant damage to the mucosal cells in the intestines, along with a dysfunctional liver in many. Therefore, lower-level supplementation of a water-dispersible or highly emulsified form of pre-formed Vitamin A may be useful.

It is very important to note that zinc is required to release the body's stores of Vitamin A for use. Zinc is frequently deficient in people with HIV. Thus, sufficient supplementation with zinc to reach healthful levels in the body is a requirement in order to gain benefit from supplementation with Vitamin A.

Note for pregnant women: While a Johns Hopkins School of Public Health study has shown that HIV-positive pregnant women who are deficient in Vitamin A are up to four times more likely to transmit HIV to their babies than those with adequate levels of Vitamin A, a later study indicates the possibility of an increase in birth defects in the babies of women who consumed more than 10,000 IU of Vitamin A per day during their pregnancy. To be safe, no pregnant woman should take more than 5,000 IU daily in order to allow for whatever dietary intake there might be. Pregnant women are advised to check any multivitamins they may be taking for the amounts that they contain.