Vitamin A and Respiratory Syncytial Virus Infection-Reply

With concern about vitamin A toxic side effects, Dr Donnelly wonders if the children with respiratory syncytial virus infection in our study¹ would have benefited more if we had given them β-carotene, a vitamin A precursor, rather than vitamin A solution. We found that a onetime oral administration of 100 000IU of vitamin A for 21 inpatient children infected with respiratory syncytial virus did not provide any measurable clinical benefit or cause vitamin A toxic effects. The dose of vitamin A in our study was based on the World Health Organization–United Nations International Children's Emergency Fund recommendations for the use of vitamin A for measles.² Evidence from African studies^3-5 have shown that vitamin A, not β-carotene, benefits patients with measles. The mean serum retinol levels in children with acute measles infection in those studies were approximately half of that in the US children with respiratory syncytial virus