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Overview HIV and vitamin D

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70 + references at Vitamin D Council


PubMed HIV or AIDS and "Vitamin D" in title) 176 items - Jan 2016

Conclusion from paper above
Low vitamin D status (serum 25-hydroxyvitamin D<32ng/mL) was significantly associated with progression to WHO HIV disease stage III or greater in multivariate models (incidence rate ratio [RR]: 1.25; 95% confidence intervals [CI]: 1.05, 1.50).
No significant relationship was observed between vitamin D status and T-cell counts during follow-up. Women with low vitamin D status had 46% higher risk of developing severe anemia during follow-up, compared to women with adequate vitamin D levels (RR: 1.46; 95% CI: 1.09, 1.96). Women in the highest vitamin D quintile had a 42% lower risk of all-cause mortality, compared to the lowest quintile (RR: 0.58; 95% CI: 0.40, 0.84).
Vitamin D status had a protective association with HIV disease progression, all-cause mortality, and development of anemia during follow-up in HIV-infected women.
If confirmed in randomized trials, vitamin D supplementation could represent a simple and inexpensive method to prolonging the time to initiation of antiretroviral therapy in HIV-infected patients, particularly in resource-limited settings.

Vitamin D Cure book talks about HIV and vitamin D deficiency

45 Intervention HIV trials using vitamin D as of Aug 2016

Intervention HIV trials


HIV vicious circles with vitamin D deficiency – Aug 2012

Review of Metabolic, Immunologic, and Virologic Consequences of Suboptimal Vitamin D Levels in HIV Infection
AIDS Patient Care and STDs, Online Ahead of Print: August 3, 2012
Allen T. Griffin atgrif01 at louisville.edu, M.D., and Forest W. Arnold, D.O., M.Sc.
School of Medicine, Department of Medicine, Division of Infectious Diseases, University of Louisville, Louisville, Kentucky.

Low 25-hydroxyvitamin D levels are common in the general and HIV-infected populations alike. Defined as levels less than 30?ng/mL, suboptimal vitamin D is known to afflict over 70% of representative samples from each group in resource-rich countries with even greater prevalence in resource-poor regions of the world.

In both those with and without HIV, dark skin, low vitamin D intake, exiguous exposure to sunlight, and season act as risk factors for suboptimal vitamin D levels.

In those infected with HIV, antiretroviral therapy, particularly non-nucleoside reverse transcriptase inhibitors (NNRTIs), increase risk for low vitamin D as well.

Furthermore, metabolic aberrations, including obesity and hyperlipidemia, and miscellaneous risk factors, such as advanced AIDS and substance abuse, have been linked to suboptimal vitamin D in those with HIV.

While the skeletal and cardiovascular systems of HIV patients may be adversely impacted as a result of low levels, recent data have also linked low vitamin D to decreased CD4 counts, higher viral loads, and to critical end points including progression to AIDS events and death. More research is needed to confirm these potential consequences of low vitamin D in those with HIV and to discern the benefits of routine screening for and treatment of low vitamin D in this population.


HIV susceptability not associated with Vitamin D

Vitamin D Levels, Natural H1N1 Infection and Response to H1N1 Vaccine among HIV-Infected Individuals
J AIDS Clinic Res 2012, 3:5 http://dx.doi.org/10.4172/2155-6113.1000152
Florence Momplaisir 1, Ian Frank 2, WA Meyer III 3, Deborah Kim 2, Rosemary Kappes 2 and Pablo Tebas 2
1 Division of General Internal Medicine, University of Pennsylvania School of Medicine, Philadelphia, USA
2 Division of Infectious Diseases, AIDS Clinical Trials Unit, Center for AIDS Research, University of Pennsylvania School of Medicine, Philadelphia, USA
3 Quest Diagnostics, Baltimore, Maryland, USA

Background: Beyond its role in calcium homeostasis, vitamin D plays a critical role in immunological responses to pathogens. We evaluated the relationship between 25-OH vitamin D levels and susceptibility to natural H1N1 infection and H1N1 vaccine responses in HIV infected individuals.

Methods: This was a sub study of an H1N1 vaccine trial conducted at the University of Pennsylvania in 2009/10. We compared the 25-OH vitamin D levels among individuals with and without baseline evidence of prior H1N1 infection and between vaccine responders and non-responders.

Results: 120 participants enrolled in the trial, 71% male, 68% African American, median age 46 years.
The majority had controlled HIV disease.
At baseline, 86% had 25-OH vitamin D levels < 30 ng/ml and 54% had levels < 20 ng/ml.
Thirty participants (25%) had evidence of prior H1N1 exposure.
There was no difference in mean 25-OH vitamin D levels among patients with or without prior natural H1N1 infection (21 ng/ml vs 20 ng/ml, p=0.72).
Among participants without previous H1N1 exposure, only 61% developed protective antibody titers following vaccination.
25-OH vitamin D levels were similar between vaccine responders (20 ng/ml) and non-responders (20 ng/ml) (p=0.83).

Conclusion: Although 25-OH vitamin D deficiency was very common among HIV-infected individuals, it was not associated with natural susceptibility to H1N1 or to vaccine responses.

PDF attached at the bottom of this page


Serum 25-hydroxyvitamin D levels and C-reactive protein in persons with HIV infection.

AIDS Res Hum Retroviruses. 2012 Sep 24.
Poudel-Tandukar K, Poudel KC, Jimba M, Kobayashi J, Johnson CA, Palmer PH.
Waseda University, Waseda Institute for Advanced Study, 1-6-1 Nishi-waseda, Shinjuku-ku, Tokyo, Japan, 1698050; kkpoudel at hotmail.com.

Human Immunodeficiency Virus (HIV) infection has been frequently associated with vitamin D deficiency as well as chronic inflammatory response. We tested the hypothesis of an independent relationship between serum concentrations of 25-hydroxyvitamin D (25[OH]D) and high-sensitivity C-reactive protein (CRP) in a cohort of HIV-positive people. A cross-sectional survey was conducted among 316 HIV-positive people (181 men and 135 women) aged 16 to 60 years residing in the Kathmandu Valley, Nepal. Serum high-sensitivity CRP concentrations and serum 25(OH)D levels were measured by the latex agglutination nephelometry method and the competitive protein-binding assay, respectively. The relationship between serum CRP concentrations and 25(OH)D serum level were assessed using multiple logistic regression analysis with adjustment of potential cardiovascular and HIV-related factors.
The proportion of participants with 25(OH)D serum level of <20ng/mL, 20-30ng/mL, and >30ng/mL were 83.2%, 15.5%, and 1.3%, respectively.
The mean 25(OH)D serum level in men and women were 15.3ng/mL and 14.4ng/mL, respectively.

Participants with 25(OH)D serum level of <20ng/mL had a 3.2-fold higher odds of high CRP (>3 mg/L) compared to those with 25(OH)D serum level of >20ng/mL (p=0.005). Men and women with 25(OH)D serum level of <20ng/mL had 3.2 and 2.7-fold higher odds of high CRP (>3 mg/L), respectively, compared to those with 25(OH)D serum level of >20ng/mL. The relationships remained significant only in men (p=0.02) but not in women (p=0.27). A risk of having high level of inflammation (CRP >3 mg/L) may be high among HIV-positive men and women with 25(OH)D serum level of <20 ng/mL.

PMID: 23003113


VitaminDWiki summary for HIV in Nepal (paper above)

  • 83% < 20 ng of vitamin D, 3.2X more likely to have high CRP
  • 99% < 30 ng of vitamin D

Study suggests vitamin D activates TLR8 receptors which recognise and fight HIV

Attached at the bottom of this page (31-HIV)


HIV with low vitamin D = 2X more likely to die - May 2014

25-Hydroxyvitamin D Insufficiency and Deficiency is Associated with HIV Disease Progression and Virological Failure Post-Antiretroviral Therapy Initiation in Diverse Multinational Settings.
J Infect Dis. 2014 May 5. [Epub ahead of print]
Havers F1, Smeaton L, Gupte N, Detrick B, Bollinger R, Hakim J, Kumarasamy N, Andrade A, Christian P, Lama JR, Campbell TB, Gupta A; for the ACTG PEARLS and NWCS 319 Study Teams.
Author information
1Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. Dr. Havers is now with the US Centers for Disease Control and Prevention, Atlanta, GA, USA, 30333.

Background. Low 25-hydroxyvitamin D (25(OH)D) has been associated with increased HIV mortality, but prospective studies assessing treatment outcomes after combination antiretroviral therapy (cART) initiation in resource-limited settings are lacking.

Methods. A case-cohort study (N=411) was nested within a randomized cART trial of 1,571 cART-naïve adults in 8 resource-limited settings and the US. The primary outcome (WHO stage 3/4 disease or death within 96 weeks of cART initiation) was met by 192 cases, and 152 and 29 cases met secondary outcomes of virologic and immunologic failure. We studied prevalence and risk factors for baseline low 25(OH)D (<32 ng/mL) and examined associated outcomes using proportional hazard models.

Results. Low 25(OH)D prevalence was 49% and ranged from 27% in Brazil to 78% in Thailand. Low 25(OH)D was associated with high BMI, winter/spring season, country-race group, and lower viral load. Baseline low 25(OH)D was associated with increased risk of HIV progression and death (adjusted hazard ratio (aHR) 2.13; 95% CI: 1.09-4.18) and virologic failure (aHR 2.42; 95% CI 1.33-4.41).

Conclusions. Low 25(OH)D is common in diverse HIV-infected populations and is an independent risk factor for clinical and virologic failure. Studies examining the potential benefit of vitamin D supplementation among HIV patients initiating cART are warranted.
PMID: 24799602


Vitamin D and HIV Infection: A Systematic Review - March 2014

The Human Immunodeficiency Virus (HIV) infects human T cells, causing a disease that progressively leads to a dramatic deterioration of the immune function. The Acquired Immunodeficiency Syndrome (AIDS) is present when CD4+ cell count is below 200 cells/mm3 or the patient has an opportunist infection, such as esophageal candidiasis or Pneumocystis pneumonia. Since life expectancy of HIV-infected individuals has increased, mostly as a result of advances in diagnosis and treatment, they are more willing to develop long-term chronic complications, some of which have been associated with vitamin D deficiency.
 Download the PDF from VitaminDWiki.


HIV - 4,000 and 7,000 IU Vitamin D were safe and effective - Feb 2015

Vitamin D₃ supplementation in Batswana children and adults with HIV: a pilot double blind randomized controlled trial.
PLoS One. 2015 Feb 23;10(2):e0117123. doi: 10.1371/journal.pone.0117123. eCollection 2015.
Steenhoff AP1, Schall JI2, Samuel J2, Seme B3, Marape M4, Ratshaa B3, Goercke I3, Tolle M4, Nnyepi MS5, Mazhani L6, Zemel BS7, Rutstein RM8, Stallings VA7.

Vitamin D Response varied with HIV ART being used
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OBJECTIVES:
Since vitamin D insufficiency is common worldwide in people with HIV, we explored safety and efficacy of high dose cholecalciferol (D₃) in Botswana, and evaluated potential modifiers of serum 25 hydroxy vitamin D change (Δ25D).

DESIGN:
Prospective randomized double-blind 12-week pilot trial of subjects ages 5.0-50.9 years.

METHODS:
Sixty subjects randomized within five age groups to either 4000 or 7000 IU per day of D₃ and evaluated for vitamin D, parathyroid hormone, HIV, safety and growth status. Efficacy was defined as serum 25 hydroxy vitamin D (25D) ≥32 ng/mL, and safety as no simultaneous elevation of serum calcium and 25D. Also assessed were HIV plasma viral RNA viral load (VL), CD4%, anti-retroviral therapy (ART) regime, and height-adjusted (HAZ), weight-adjusted (WAZ) and Body Mass Index (BMIZ) Z scores.

RESULTS:
Subjects were 50% male, age (mean±SD) 19.5±11.8 years, CD4% 31.8±10.4, with baseline VL log₁₀ range of <1.4 to 3.8 and VL detectable (>1.4) in 22%. From baseline to 12 weeks, 25D increased from 36±9 ng/ml to 56±18 ng/ml (p<0.0001) and 68% and 90% had 25D ≥32 ng/ml, respectively (p = 0.02). Δ25D was similar by dose. No subjects had simultaneously increased serum calcium and 25D. WAZ and BMIZ improved by 12 weeks (p<0.04). HAZ and CD4% increased and VL decreased in the 7000 IU/d group (p<0.04). Younger (5-13y) and older (30-50y) subjects had greater Δ25D than those 14-29y (26±17 and 28±12 vs. 11±11 ng/ml, respectively, p≤0.001). Δ25D was higher with efavirenz or nevirapine compared to protease inhibitor based treatment (22±12, 27±17, vs. 13±10, respectively, p≤0.03).

CONCLUSIONS:
In a pilot study in Botswana, 12-week high dose D₃ supplementation was safe and improved vitamin D, growth and HIV status; age and ART regimen were significant effect modifiers.

TRIAL REGISTRATION: ClinicalTrials.gov NCT02189902.
PMID: 25706751

 Download the PDF from VitaminDWiki

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Attached files

ID Name Comment Uploaded Size Downloads
6282 Response vs ART.jpg admin 2015-12-28 22:06 22.94 Kb 670
6281 Batswana.pdf PDF 2015 admin 2015-12-28 22:03 728.52 Kb 307
4573 Vitamin D and HIV Infection - Systematic Review - March 2014.pdf PDF 2014 admin 2014-11-14 01:26 705.56 Kb 878
4337 Anti-Inflammatory and Antimicrobial Actions of Vitamin D in Combating TB or HIV.pdf PDF 2013 admin 2014-09-03 12:20 1.19 Mb 716
1905 31-HIV TLR Vit D Campbell.pdf PDF admin 2013-01-03 01:14 1.95 Mb 1709
1510 HIV susceptability not assocatied with Vitamin D.pdf PDF admin 2012-08-06 23:56 1.72 Mb 1230
909 HIV and vitamin D.jpg admin 2011-12-02 01:48 10.26 Kb 3479
250 HIV mortality etc.PDF admin 2010-10-23 13:45 211.37 Kb 1678
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