Vitamin D Supplementation Decreases Immune Activation and Exhaustion in HIV-1-Infected Youth

Eckard, Allison Ross; O’Riordan, Mary Ann; Rosebush, Julia C.; Lee, Seungeun Thera; Habib, Jakob; Ruff, Joshua H.; Labbato, Danielle; Daniels, Julie E.; Uribe-Leitz, Monika; Tangpricha, Vin; Chahroudi, Ann; McComsey, Grace A.

doi:10.3851/imp3199

Cited by 48 publications

(40 citation statements)

References 30 publications

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“…reported that plasma 25(OH)D levels were significantly positively correlated with CD4 + T‐cell counts after 24 weeks of VitD supplementation and that each 1.0 ng/ml increase in 25(OH)D during repletion therapy was associated with a 3.3 cell/µl increase in the CD4 + T‐cell count . Although others have found that VitD supplementation is associated with reduced immune activation and CD4 + T‐cell exhaustion levels, it has no effect on CD4 + T‐cell recovery in both untreated and treated HIV‐1‐infected individuals . Therefore, additional investigation is needed to determine whether VitD can promote immune reconstitution.…”

Section: Intervention Measures For Poor Immune Reconstitutionmentioning

confidence: 99%

“…217 Although others have found that VitD supplementation is associated with reduced immune activation and CD4 + T-cell exhaustion levels, it has no effect on CD4 + T-cell recovery in both untreated and treated HIV-1-infected individuals. [218][219][220] Therefore, additional investigation is needed to determine whether VitD can promote immune reconstitution.…”

Section: -Infected Individuals Receiving the Dolutegravir-abacavir-lmentioning

confidence: 99%

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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

191

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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Section: Intervention Measures For Poor Immune Reconstitutionmentioning

confidence: 99%

Section: -Infected Individuals Receiving the Dolutegravir-abacavir-lmentioning

confidence: 99%

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

Yang

Zhang

et al. 2020

Journal of Leukocyte Biology

191

214

View full text Add to dashboard Cite

show abstract

“…After 12 months of supplementation, 25(OH)D increased from 17 (11, 21) ng/mL to 31 (22, 37) ng/mL in the control group and from 18 (14, 22) ng/mL to 42 (33, 53) ng/mL in the combined medium and high dose groups (within and between groups p<0.001), but there were no differences between groups in changes in BMD or bone markers(80**). Notably, supplementation decreased markers of T-cell activation and exhaustion and monocyte activation regardless of the dose; although, participants given the highest dose showed the greatest improvements(81). Collectively, these studies suggest that there is a role for vitamin D supplementation in HIV-infected patients initiating ART and while undergoing treatment with alendronate for low BMD, but the effect of supplementation outside of these two settings is unclear.…”

Section: Vitamin D and Bone In Hivmentioning

confidence: 99%

Vitamin D and bone loss in HIV

Hileman

Overton

McComsey³

2016

Current Opinion in HIV and AIDS

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Purpose of review Bone health has become an increasingly important aspect of the care of HIV-infected patients as bone loss with antiretroviral therapy (ART) initiation is significant and osteopenia and osteoporosis are highly prevalent. Vitamin D is tightly linked to calcium balance and bone health and vitamin D deficiency is common in HIV. This review outlines the epidemiology of vitamin D deficiency in HIV, summarizes our current understanding of the relationship between vitamin D and bone loss in HIV and the impact of vitamin D supplementation in this patient group. Recent findings While data are conflicting as to whether vitamin D deficiency is more prevalent among HIV-infected individuals than in the general population, there are several reasons for why this patient group may be at heightened risk. Studies linking vitamin D deficiency to bone loss in HIV are limited; however, data from randomized clinical trials suggest a benefit of vitamin D supplementation for the prevention of bone loss with ART initiation and for the treatment of bone loss with bisphosphonate therapy. Summary There are too limited data to recommend universal screening of vitamin D status or supplementation to all HIV-infected individuals. However, testing 25-hydroxyvitamin D levels in those at risk for deficiency and treating patients found to be deficient or initiating antiretroviral therapy or bisphosphonate therapy should be considered. Further study on vitamin D supplementation is needed regarding the potential benefit on immune activation and restoration in this patient group.

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“…Studies about vitamin D supplementation in HIV-positive populations have been conducted [ 6 – 14 ]. However, indirect comparisons of these studies lead to equivocal conclusions, while direct comparative studies are limited [ 15 , 16 ]. As HIV infection itself as well as different antiretroviral drugs significantly influence bone, calcium, and vitamin D metabolism [ 17 ], it is unclear whether the results of previous studies about the dosing regimens of cholecalciferol supplementation in general populations apply to PLWH.…”

Section: Introductionmentioning

confidence: 99%

Monthly or Weekly Supplementation with Cholecalciferol 20,000 IU in People Living with HIV: Results from a Nested Cohort Study

Noe

Moeckel

Schwerdtfeger

et al. 2018

Interdisciplinary Perspectives on Infectious Diseases

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Background There is still considerable uncertainty in handling vitamin D deficiency in people living with HIV (PLWH), due to a lack of comparative data and the wide range of recommended daily intake. Nondaily supplementation might be preferred in many PLWH, but recommendation on dosing has not been established. We aimed to compare the efficacy of weekly versus monthly supplementation with cholecalciferol 20,000 IU in a group of PLWH with vitamin D deficiency in Western Europe. Study Design Longitudinal, retrospective nested cohort study of PLWH from two large clinical care centers in Munich, Germany. Results Of 307 patients with vitamin D deficiency, 124 patients received vitamin D supplementation (weekly supplementation in 84 (67.7%)). 46.4% and 22.5% of patients achieved 25(OH)D levels ≥30 ng/mL after 12 months of weekly and monthly supplementation with cholecalciferol 20,000 IU, respectively (p=0.011). Dosing interval as well as 25(OH)D baseline levels >15 ng/mL were associated with the normalization of 25(OH)D. Conclusion A higher rate of 25(OH)D level normalization can be achieved via weekly supplementation. For several PLWH, even a weekly dose of cholecalciferol 20,000 IU might not be adequate to maintain 25(OH)D levels >30 ng/mL without an initial “loading” dose. The response to supplementation is poorly predictable at an individual level.

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Vitamin D Supplementation Decreases Immune Activation and Exhaustion in HIV-1-Infected Youth

Cited by 48 publications

References 30 publications

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

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

Vitamin D and bone loss in HIV

Monthly or Weekly Supplementation with Cholecalciferol 20,000 IU in People Living with HIV: Results from a Nested Cohort Study

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