Vitamin D Deficiency and Metabolism in HIV-Infected and HIV-Uninfected Men in the Multicenter AIDS Cohort Study

AIDS Research and Human Retroviruses

Estrella

et al. 2017

Self Cite

Vitamin D may play an important role in a range of disease processes. In the general population, lower vitamin D levels have been associated with kidney dysfunction. HIV-infected populations have a higher risk of chronic kidney disease. Few studies have examined the link between lower vitamin D levels and kidney function decline among HIV-infected persons. We investigated the associations of serum 25-hydroxyvitamin D [25(OH)D] and 1,25-dihydroxyvitamin D [1,25(OH)D] with kidney function decline in a cohort of HIV-infected white and black men under highly active antiretroviral therapy treatment in the vitamin D ancillary study of the Multicenter AIDS Cohort Study. The associations of 25(OH)D and 1,25(OH)D with annual change in estimated glomerular filtration rate (eGFR) were evaluated using linear mixed effects models. This study included 187 whites and 86 blacks with vitamin D measures and eGFR ≥60 ml/min/1.73 m at baseline. Over a median follow-up of 8.0 years, lower 25(OH)D levels were significantly associated with faster eGFR decline in whites (adjusted annual change in eGFR, tertile 1: -2.06 ml/min/1.73 m vs. tertile 3: -1.23 ml/min/1.73 m, p trend .03), while no significant association was detected in blacks. Lower 1,25(OH)D was associated with faster kidney function decline in both whites and blacks, although the estimates were not statistically significant. In conclusion, lower 25(OH)D levels were significantly associated with faster eGFR decline in a cohort of HIV-infected white men, but not in those with black ancestry. Further research is warranted to investigate the association of 25(OH)D and 1,25(OH)D with kidney function decline in larger and ethnically diverse populations.

Section: Study Populationmentioning

confidence: 99%

Vitamin D Status and Kidney Function Decline in HIV-Infected Men: A Longitudinal Study in the Multicenter AIDS Cohort Study

Tin

AIDS Research and Human Retroviruses

Estrella

et al. 2017

Self Cite

“…A prior study of 54 HIV-infected patients and 20 controls found lower levels of 1,25(OH) 2 D to be associated with HIV-infection but not with CD4 count, but 27 patients met criteria for AIDS, which may represent a different population and immune context [35]. Prior reports from the MACS vitamin D substudy found no difference in median 1,25[OH] 2 D level by HIV serostatus (median 45.0 pg/mL in HIV-infected and 45.1 pg/mL in HIV-uninfected [27]). It must be emphasized that the reliability of 1,25(OH) 2 D was modest (ρ=0.34 between repeated measures) and levels are known to be transient.…”

Section: Discussionmentioning

confidence: 99%

“…For the present study, we included men with pre- or post-HAART vitamin D metabolite measurements from the MACS vitamin D substudy [27], who had at least one post-HAART CD4 measurement and evidence of viral suppression (defined as at least one HIV RNA measurement <500 copies/ml within 2 years of starting HAART) following HAART initiation. Included men were followed from HAART initiation (defined as the midpoint between last observed time not on HAART to first observed time on HAART) until viral failure (defined as HIV RNA measurement >500 copies/ml 2 years or more after starting HAART) or last CD4 measurement.…”

Section: Methods and Methodsmentioning

confidence: 99%

Vitamin D status and immune function reconstitution in HIV-infected men initiating therapy

Abraham

Calkins

et al. 2018

Aids

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“…Covariates for inclusion in the analysis were drawn from prior work in the MACS evaluating correlates of vitamin D metabolite levels. 16 Covariate values were assessed at the time point of the vitamin D metabolite measurements. Enzymelinked immunosorbent assays along with confirmatory Western blot determined HIV status (HIV infected vs. HIV uninfected).…”

Section: Covariatesmentioning

confidence: 99%

“…We selected covariates into the final model based on literature 21 and previous study results. 16 Final models were adjusted for age >50 years, BMI, and HCV infection and were run stratified by HIV status.…”

Section: Statistical Analysesmentioning

confidence: 99%

Vitamin D Metabolites in Aging HIV-Infected Men: Does Inflammation Play a Role?

AIDS Research and Human Retroviruses

Brown

Margolick

et al. 2018

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The inflammatory context of HIV infection has been posited to contribute to the higher comorbidity risk noted in HIV-infected populations. One possible pathway may involve 1,25-dihydroxyvitamin D [1,25(OH) 2 D], which plays a wide biologic role in many tissues. We sought to investigate whether inflammation was associated with vitamin D metabolites in a cohort of HIV-infected (HIV+) men receiving treatment and HIV-uninfected (HIV-) men. Vitamin D metabolites, including 25-hydroxyvitamin D [25(OH)D] and 1,25(OH) 2 D, were measured along with 24 inflammatory markers among Multicenter AIDS Cohort Study participants. Exploratory factor analysis reduced inflammatory marker data to a smaller set of inflammatory processes (IPs). Multivariate linear regression was used to evaluate associations between vitamin D metabolites and IPs. There were 466 HIV+ and 100 HIVmen, who contributed 658 stored samples from 1998 to 2008. We found three IPs with IP 1 characterized by sTNF-R2, sIL-2Ra, sCD27, BAFF, sgp130, sCD14, CXCL10 (IP-10), and sIL-6R. While none of the three IPs was associated with 25(OH)D levels in either HIV+ or HIV-, higher levels of IP 1 were significantly associated with the reduced levels of 1,25(OH) 2 D in HIV+, and a similar although nonsignificant trend was seen in HIV-. The association between 1,25(OH) 2 D and inflammation found among HIV-infected men suggests a possible mechanism whereby inflammation leads to the increased comorbidity risk noted among HIV-infected individuals.