HIV or vitamin D deficiency?

The aim of the current study was to further assess the short-and long-term prognostic value of vitamin D deficiency for AIDS-defining and non-AIDS-defining events and death and to study the association of vitamin D deficiency with inflammatory markers.

…Although the odds of death were not associated with the baseline vitamin D level, they “decreased significantly by 46% for a 2-fold higher level of 25-hydroxyvitamin D,” Dr. Viard reported.

…”Vitamin D was lower in cases of death than in controls, but only for the latest sample, while interleukin-6 [IL-6] was higher in cases than in controls for all items,” Dr. Viard said.

“Similarly, CRP [C-reactive protein] was higher in cases than in controls at the latest sample for AIDS-events and death, and it was also higher at baseline for people who were going to die.  CD14 levels were higher in cases and in controls for AIDS events and death.”

The percent change in the level of inflammatory biomarkers and the CD4 cell count reflected the vitamin D status. If patients were severely vitamin D deficient (<10 ng/mL), high-sensitivity  IL-6, and high-sensitivity CRP increased by 4.66% per year and by 8.35% per year after adjustment for several variables, including season, sex, age, and region of residency. There was no change in these markers if patients had normal or moderately deficient vitamin D levels.

Soluble CD14 increased regardless of vitamin D status. CD4 counts increased by 7.00% per year for people deficient in vitamin D and by 11.14% per year for people nondeficient in vitamin D (both  P < .01), but not at all for patients who were severely deficient.

Asked for perspective on these findings, session cochair Andrea Antinori, MD, from the National Institute for Infectious Disease in Rome, Italy, who was not involved with the study, told   Medscape Medical News that he found the results interesting because “probably we don’t have much information about the role of vitamin D, and more interestingly, not only its role in bone mineral density and fracture in the long term but even in immune activation inflammatory pathways” that can increase other risks, for example, for cardiovascular disease.

In regards to Antinori’s words, our lack of knowledge on vitamin D’s immune-enhancing effects means that we cannot rule out vitamin D deficiency as a cause of AIDS itself.

It is interesting to note that the article makes no reference to HIV after the headline.

[Source: Medscape]

The author of this blog has written about AIDS and vitamin D in Prescribing Sunshine: Why vitamin D should be flying off shelves.

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