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Clin Nutr. 2016 Oct;35(5):1110-7. doi: 10.1016/j.clnu.2015.08.007. Epub 2015 Sep 5.

Vitamin-D deficiency impairs CD4+T-cell count recovery rate in HIV-positive adults on highly active antiretroviral therapy: A longitudinal study.

Author information

1
Department of Epidemiology & Biostatistics, The University of Georgia, B.S. Miller Hall Room 125, 101 Buck Rd, Athens, GA, USA. Electronic address: aezeamam@uga.edu.
2
School of Public Health, and Makerere University College of Health Sciences, Kampala, Uganda.
3
Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
4
School of Public Health, and Makerere University College of Health Sciences, Kampala, Uganda; Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA.
5
Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda.
6
Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA.
7
Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda; Division of Infectious Diseases, Department of Medicine, John Hopkins University, Baltimore, MD, USA.
8
Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA; Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.

Abstract

BACKGROUND & AIMS:

We implemented a prospective study among human immunodeficiency virus (HIV)-positive adults to examine the association between vitamin-D deficiency (VDD) and insufficiency (VDI) vs sufficiency (VDS) and CD4+T-cell improvement over 18 months of highly active antiretroviral therapy (HAART).

METHODS:

We used data from a randomized placebo-controlled micronutrient trial with 25-hydroxy vitamin-D (25(OH)D) measured at enrollment in 398 adults. CD4+T-cell count was measured repeatedly at months 0, 3, 6, 12 and 18. Linear mixed models quantified the vitamin-D-related differences in CD4+T-cell count and associated 99% confidence intervals at baseline and respective follow-up intervals.

RESULTS:

At baseline 23%, 60% and 17% of participants were VDS, VDI and VDD, respectively. Absolute CD4+T- cell counts recovered during follow-up were persistently lower for baseline VDD and VDI relative to VDS participants. The greatest deficit in absolute CD4+T-cells recovered occurred in VDD vs VDS participants with estimates ranging from a minimum deficit of 26 cells/μl (99% CI: -77, 26) to a maximum deficit of 65 cells/μl (99% CI: -125, -5.5) during follow-up. This VDD-associated lower absolute CD4+T-cell gain was strongest among patients 35 years old or younger and among participants with a baseline body mass index of less than 25 kg/m(2).

CONCLUSIONS:

VDD is associated with lower absolute CD4+T-cell count recovery in HIV-positive patients on HAART. Vitamin-D supplementation may improve CD4+T-cell recovery during HAART. However, future intervention studies are needed to definitively evaluate the effectiveness of this vitamin as an adjunct therapy during HAART.

KEYWORDS:

Antiretroviral therapy; CD4+; HIV; Immune recovery; T-cell count; Vitamin-D

PMID:
26371397
PMCID:
PMC5289410
DOI:
10.1016/j.clnu.2015.08.007
[Indexed for MEDLINE]
Free PMC Article

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