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AIDS. 2014 Nov 28;28(18):2677-82. doi: 10.1097/QAD.0000000000000472.

Vitamin D supplementation is associated with reduced immune activation levels in HIV-1-infected patients on suppressive antiretroviral therapy.

Author information

1
aSorbonne Universités, UPMC Univ Paris, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris) bINSERM, U1135, CIMI-Paris cSorbonne université, UPMC Univ Paris 06, UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health dINSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique eAP-HP, Groupe hospitalier Pitié-Salpêtrière, Service des Maladies Infectieuses et Tropicales fAP-HP, Hôtel-Dieu, Centre de Diagnostic et de Thérapeutique gCochin Hospital, Infectious Pathology Unit, France and Paris Descartes University, Infectious Pathology Unit hEA 7327 Université Paris-Descartes, Sorbonne Paris Cité, Paris, France.

Abstract

BACKGROUND:

A majority of HIV-1-infected patients present a severe deficit in vitamin D, which predicts short-term mortality. Vitamin D is a naturally synthesized hormone, with important immunomodulatory functions. In the general population, its deficit has been associated with increased markers of inflammation. Vitamin D deficit may therefore play a role in the establishment of elevated systemic immune activation, which persists despite suppressive antiretroviral therapy (ART) in HIV-infected patients, and is predictive of disease progression; and vitamin D supplementation may be beneficial in this context.

METHODS:

We performed both a cross-sectional study (vitamin D deficit versus normal level) and a longitudinal study (upon vitamin D supplementation for 6 to 12 months) of HIV-1-infected patients receiving suppressive ART. The primary outcome measure was the percentage of activated memory CD8(+) T cells in blood, which is a robust marker associated with disease progression. Secondary outcomes included general T-lymphocyte and B-lymphocyte phenotype.

RESULTS:

Although vitamin D deficiency had no influence on T-cell and B-cell subset distribution, we found an association between vitamin D and immune activation levels in HIV-1-infected patients. Vitamin D supplementation in vitamin D-deficient patients resulted in reduced immune activation levels.

CONCLUSION:

The present data support the rationale of vitamin D supplementation in the routine clinical management of HIV-1-infected patients, in order to decrease immune activation levels and possibly improve long-term survival.

PMID:
25493593
DOI:
10.1097/QAD.0000000000000472
[Indexed for MEDLINE]

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