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February 13, 2013

Standard-Dose vs High-Dose Multivitamin Supplements for HIV—Reply

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: Departments of Nutrition (Dr Isanaka; sisanaka@hsph.harvard.edu) and Global Health and Population (Dr Fawzi), Harvard School of Public Health, Boston, Massachusetts; and Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania (Dr Mugusi).

JAMA. 2013;309(6):545-546. doi:10.1001/jama.2012.216995

In Reply: Drs Padayatty and Levine highlight the familiar challenge in selecting doses for trials of multivitamin efficacy and suggest that the null findings in our study of high-dose vs standard-dose multivitamin supplements among patients with HIV initiating antiretroviral therapy may have been due to the location of the selected doses on the average micronutrient dose-response curves. We agree that the micronutrient requirements and metabolism in individuals with HIV are not well understood.