To the Editor: Fawzi and coworkers (July 1 issue)1 demonstrate the benefit of multivitamin supplementation in pregnant women with human immunodeficiency virus (HIV) infection. What is most impressive is that the effects of vitamins on the immune system, on disease progression, and on mortality appear to be secondary to immune-system restoration. Overwhelming but exhausted cellular immune activation, characterized by activated T cells that are prone to apoptosis, and impairment of the ability of the immune system to restrict the growth of secondary pathogens are key features in the pathogenesis of HIV infection.2 Excessive production of reactive oxygen species by activated
