Vitamin D is Linked to Carotid Intima-Media Thickness and Immune Reconstitution in HIV-Positive Individuals

Ross, Alistair; Judd, Suzanne E.; Kumari, Meena; Hileman, Corrilynn Olesky; Storer, Norma; Labbato, Danielle; Tangpricha, Vin; McComsey, Grace A.

doi:10.3851/imp1784

Cited by 80 publications

(102 citation statements)

References 49 publications

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“…29 Although some authors presented evidence in support of a relationship between CD4 T-cell count and 25OHD levels (with lower CD4 T-cell count associated with higher prevalence of vitamin D deficiency or lower 25OHD concentrations), 9,23,38,42 at least three large, well-designed trials failed to identify such association. 27,31,41 Considering other HIV-related risk factors, patchy correlations were found between HIV viral load, duration of ART, duration of HIV, plasma neopterin, or soluble tumor necrosis factor-alpha receptor I and vitamin D deficiency.…”

Section: Vitamin D Deficiencymentioning

confidence: 99%

“…Considering the main findings and studies undertaken in large populations, only some specif ic ART classes or agents were clearly found to be related to hypovitaminosis D. 9,10,23,24,26,[29][30][31][33][34][35]37,38,40,42,35 Several authors demonstrated that non-nucleoside reverse transcriptase inhibitor (NNRTI) use was associated with 25OHD deficiency. 10,35,37,40,45,51 For efavirenz, in particular, an association with low 25OHD concentration has often been suggested.…”

Section: Vitamin D Deficiencymentioning

confidence: 99%

“…27,31,41 Considering other HIV-related risk factors, patchy correlations were found between HIV viral load, duration of ART, duration of HIV, plasma neopterin, or soluble tumor necrosis factor-alpha receptor I and vitamin D deficiency. 6,8,9,23,25,28,37,52,54,57 Adverse health outcomes related to vitamin D deficiency in HIV-infected patients Very few studies investigated the detrimental effects of vitamin D deficiency on health outcomes other than bone diseases in HIV+. They were primarily cross-sectional correlation analyses, and it was therefore not possible to establish a cause-effect relationship.…”

Section: Vitamin D Deficiencymentioning

confidence: 99%

“…The vast majority of studies were performed in Europe and the United States (28 articles), and most of them were crosssectional analyses. Nine studies compared vitamin D status between HIV+ and "healthy" subjects, 9,23,25,27,30,31,34,42,60 but only three of them were matched case-control analyses. 27,30,34 Overall, the studies were heterogeneous in terms of demographic and clinical characteristics of populations included.…”

Section: Literature Searchmentioning

confidence: 99%

“…27,30,34 Stein et al and Yin et al recruited controls of identical gender (women) and menopausal status (post-and pre-menopausal, respectively) as the HIV cases. 42,60 In the remaining four articles, authors used unmatched controls, as follows: healthy subjects from the community or the clinic (n = 2), 23 uninfected at-risk subjects with the same gender (n = 1). 9 Results from these reports were quite inconsistent (Figures 2 and 3).…”

Section: Vitamin D Deficiencymentioning

confidence: 99%

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Vitamin D deficiency in HIV-infected patients: a systematic review

Giusti¹,

Penco²,

Pioli³

2011

NDS

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Advances in the diagnosis and management of human immunodeficiency virus (HIV) have resulted in a dramatic decrease in mortality in HIV-infected individuals (HIV+). The subsequent increase in life expectancy of HIV+ has led to the need to consider the long-term complications of the disease and its treatment. Abnormalities in vitamin D status and metabolism are increasingly recognized as a major concern in HIV infection. In the last 5 years a number of cross-sectional and prospective studies have suggested a high prevalence of vitamin D deficiency in HIV+. Although few case-control studies have been published, it has been suggested that the prevalence of hypovitaminosis D in HIV+ is higher than in the general population, and at least in part, is related to the course of the disease and/or the antiretroviral drugs used to treat the disease. An adequate vitamin D status is important not only for bone tissue, but also for the global health status of HIV+ individuals, since a growing body of evidence has demonstrated the detrimental effects of vitamin D deficiency on multiple health outcomes. Therefore, definition of the size of the problem and identification of effective protocols for the prevention and management of vitamin D deficiency in HIV+ patients represent important steps in improving health status and reducing long-term chronic complications in individuals with HIV. Due to its immunomodulatory effects, vitamin D may also have implications in the progression of HIV infection. This systematic review was designed to determine the prevalence of vitamin D deficiency in HIV+ patients; to identify risk factors (related to the HIV infection or not) potentially associated with this condition; to describe the potential consequences of hypovitaminosis D on the course of the infection and the benefits of vitamin D repletion; and to make some suggestions about the future, considering the limitations of previous studies.

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Section: Vitamin D Deficiencymentioning

confidence: 99%

Section: Vitamin D Deficiencymentioning

confidence: 99%

Section: Vitamin D Deficiencymentioning

confidence: 99%

Section: Literature Searchmentioning

confidence: 99%

Section: Vitamin D Deficiencymentioning

confidence: 99%

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Vitamin D deficiency in HIV-infected patients: a systematic review

Giusti¹,

Penco²,

Pioli³

2011

NDS

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Micronutrient supplementation in adults with HIV infection

Visser¹,

Durão

Sinclair

et al. 2017

Cochrane Database of Systematic Reviews

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Background Micronutrient deficiencies are common among adults living with HIV disease, particularly in low‐income settings where the diet may be low in essential vitamins and minerals. Some micronutrients play critical roles in maintenance of the immune system, and routine supplementation could therefore be beneficial. This is an update of a Cochrane Review previously published in 2010. Objectives To assess whether micronutrient supplements are effective and safe in reducing mortality and HIV‐related morbidity of HIV‐positive adults (excluding pregnant women). Search methods We performed literature searches from January 2010 to 18 November 2016 for new randomized controlled trials (RCTs) of micronutrient supplements since the previous review included all trials identified from searches prior to 2010. We searched the CENTRAL (the Cochrane Library), Embase, and PubMed databases. Also we checked the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) and the ClinicalTrials.gov trials registers. We also checked the reference lists of all new included trials. Selection criteria We included RCTs that compared supplements that contained either single, dual, or multiple micronutrients with placebo, no treatment, or other supplements. We excluded studies that were primarily designed to investigate the role of micronutrients for the treatment of HIV‐positive participants with metabolic morbidity related to highly active antiretroviral therapy (HAART). Primary outcomes included all‐cause mortality, morbidity, and disease progression. Data collection and analysis Two review authors independently selected trials for inclusion, and appraised trial quality for risk of bias. Where possible, we presented results as risk ratios (RR) for dichotomous variables, as hazard ratios (HRs) for time‐to‐event data, and as mean differences (MD) for continuous variables, each with 95% confidence intervals (CIs). Since we were often unable to pool the outcome data, we tabulated it for each comparison. We assessed the certainty of the evidence using the GRADE approach. Main results We included 33 trials with 10,325 participants, of which 17 trials were new trials. Ten trials compared a daily multiple micronutrient supplement to placebo in doses up to 20 times the dietary reference intake, and one trial compared a daily standard dose with a high daily dose of multivitamins. Nineteen trials compared supplementation with single or dual micronutrients (such as vitamins A and D, zinc, and selenium) to placebo, and three trials compared different dosages or combinations of micronutrients. Multiple micronutrients We conducted analyses across antiretroviral therapy (ART)‐naive adults (3 trials, 1448 participants), adults on antiretroviral therapy (ART) (1 trial, 400 participants), and ART‐naive adults with concurrent active tuber...

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Incomplete immune reconstitution in HIV/AIDS patients on antiretroviral therapy: Challenges of immunological non-responders

Yang

Zhang

et al. 2020

Journal of Leukocyte Biology

190

214

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The morbidity and mortality of HIV type‐1 (HIV‐1)‐related diseases were dramatically diminished by the grounds of the introduction of potent antiretroviral therapy, which induces persistent suppression of HIV‐1 replication and gradual recovery of CD4+ T‐cell counts. However, ∼10–40% of HIV‐1‐infected individuals fail to achieve normalization of CD4+ T‐cell counts despite persistent virological suppression. These patients are referred to as “inadequate immunological responders,” “immunodiscordant responders,” or “immunological non‐responders (INRs)” who show severe immunological dysfunction. Indeed, INRs are at an increased risk of clinical progression to AIDS and non‐AIDS events and present higher rates of mortality than HIV‐1‐infected individuals with adequate immune reconstitution. To date, the underlying mechanism of incomplete immune reconstitution in HIV‐1‐infected patients has not been fully elucidated. In light of this limitation, it is of substantial practical significance to deeply understand the mechanism of immune reconstitution and design effective individualized treatment strategies. Therefore, in this review, we aim to highlight the mechanism and risk factors of incomplete immune reconstitution and strategies to intervene.

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Vitamin D is Linked to Carotid Intima-Media Thickness and Immune Reconstitution in HIV-Positive Individuals

Cited by 80 publications

References 49 publications

Vitamin D deficiency in HIV-infected patients: a systematic review

Vitamin D deficiency in HIV-infected patients: a systematic review

Micronutrient supplementation in adults with HIV infection

Incomplete immune reconstitution in HIV/AIDS patients on antiretroviral therapy: Challenges of immunological non-responders

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