Vitamin D and clinical disease progression in HIV infection: results from the EuroSIDA study

Viard, Jean-Paul, Souberbielle, Jean-Claude, Kirk, Ole, Reekie, Joanne, Knysz, Brygida, Losso, Marcelo, Gatell, Jose, Pedersen, Court, Bogner, Johannes R, Lundgren, Jens D, Mocroft, Amanda, The EuroSIDA Study Group, and Fisher, Martin (2011) Vitamin D and clinical disease progression in HIV infection: results from the EuroSIDA study. AIDS, 25 (10). pp. 1305-1315. ISSN 0269-9370

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Abstract

BACKGROUND

We examined the association between vitamin D [25(OH)D] level and disease progression in HIV infection.

METHODS

Within the EuroSIDA study, 2000 persons were randomly selected for 25(OH)D measurement in stored plasma samples closest to study entry. 25(OH)D results were stratified into tertiles. Factors associated with 25(OH)D levels and associations of 25(OH) levels with subsequent risk of all-cause mortality, AIDS and non-AIDS events were analyzed.

RESULTS

Of 1985 persons with 25(OH)D levels available, 23.7% had 25(OH)D below 10, 65.3% between 10 and 30, and 11% above 30 ng/ml. At the time of 25(OH)D measurement, older persons, persons of black ethnic origin, living outside Southern Europe/Argentina, sampled during winter, and infected with HIV through nonhomosexual exposure were at higher odds of having low 25(OH)D levels, whereas persons receiving protease inhibitors were at lower odds. Compared to those in the lowest 25(OH)D tertile (<12 ng/ml), those in the middle (12-20) and higher (>20) tertiles had a significantly lower risk of clinical progression during subsequent follow-up. Adjusted incidence rate ratios for all-cause mortality were 0.68 (95% CI 0.47-0.99, P = 0.045) and 0.56 (95% CI 0.37-0.83, P = 0.0039), and for AIDS events were 0.58 (95% CI 0.39-0.87, P = 0.0086) and 0.61 (95% CI 0.40-0.93, P = 0.020), for the middle and higher tertiles, respectively. There was a similar, nonsignificant reduced incidence of non-AIDS events in the middle and higher tertiles.

CONCLUSION

25(OH)D deficiency was frequent in HIV-infected persons (83% on combined antiretroviral therapy), and was independently associated with a higher risk of mortality and AIDS events. Causality relationships should be examined, because of potential public health consequences.

Item Type: Article
Additional Information: Martin Fisher is not a named author on this journal article but is a member of the EuroSIDA Study Group.
Schools and Departments: Brighton and Sussex Medical School > Brighton and Sussex Medical School
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine > RA0643 Communicable diseases and public health > RA0644 Individual diseases or groups of diseases, A-Z > RA0644.A25 AIDS. HIV infections
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Depositing User: Ellen Thomas
Date Deposited: 14 Feb 2014 12:48
Last Modified: 14 Feb 2014 14:34
URI: http://sro.sussex.ac.uk/id/eprint/47507
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