Prognostic Value of Vitamin D Level for All-cause Mortality, and Association With Inflammatory Markers, in HIV-infected Persons

• Published in: The Journal of infectious diseases Vol. 210; no. 2; pp. 234 - 243
• Main Authors: Shepherd, Leah, Souberbielle, Jean-Claude, Bastard, Jean-Philippe, Fellahi, Soraya, Capeau, Jaqueline, Reekie, Joanne, Reiss, Peter, Blaxhult, Anders, Bickel, Markus, Leen, Clifford, Kirk, Ole, Lundgren, Jens D., Mocroft, Amanda, Viard, Jean-Paul
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 15.07.2014
• Subjects: Adult; AIDS; Antiretrovirals; Antivirals; Biological and medical sciences; Biomarkers; Biomarkers - blood; Cohort Studies; Disease Progression; Female; Fundamental and applied biological sciences. Psychology; HIV; HIV infections; HIV Infections - diagnosis; HIV Infections - immunology; HIV Infections - mortality; HIV Infections - pathology; HIV/AIDS; Human immunodeficiency virus; Human viral diseases; Humans; Infectious diseases; Inflammation; Male; Medical sciences; Medicin och hälsovetenskap; Microbiology; Middle Aged; Prognosis; Prospective Studies; Survival Analysis; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Vitamin D; Vitamin D - blood; Vitamin D deficiency; Human; Infection; Immunopathology; Vitamin D; Viral disease; AIDS; Immune deficiency; C-reactive protein; HIV; inflammation; vitamin D; soluble CD14; all-cause death; IL-6
• ISSN: 0022-1899; 1537-6613; 1537-6613
• DOI: 10.1093/infdis/jiu074

Background. Low 25-hydroxyvitamin D (25(OH)D) has been associated with inflammation, human immunodeficiency virus (HIV) disease progression, and death. We aimed to identify the prognostic value of 25(OH) D for AIDS, non-AIDS-defining events and death, and its association with immunological/inflammatory markers. Methods. Prospective 1-1 case-control study nested within the EuroSIDA cohort. Matched cases and controls for AIDS (n = 50 matched pairs), non-AIDS-defining (n = 63) events and death (n = 41), with plasma samples during follow-up were selected. Conditional logistic regression models investigated associations between 25(OH)D levels and annual 25(OH)D change and the probability of events. Mixed models investigated relationships between 25(OH) D levels and immunological/inflammatory markers. Results. In sum, 250 patients were included. Median time between first and last sample and last sample and event was 44.6(interquartile range [IQR]: 22.7-72.3) and 3.1(IQR: 1.4-6.4) months. Odds of death decreased by 46.0%(95% confidence interval [CI], 2.0-70.0, P= .04) for a 2-fold increase in latest 25(OH) D level. There was no association between 25(OH) D and the occurrence of AIDS or non-AIDS-defining events (P >.05). In patients with current 25(OH) D < 10 ng/mL, hsIL-6 concentration increased by 4.7%(95% CI, .2,9.4, P =.04) annually after adjustment for immunological/inflammatory markers, and no change in hsCRP rate was observed (P =.76). Conclusions. Low Vitamin D predicts short term mortality in HIV-positive persons. Effectiveness of vitamin D supplementation on inflammation and patient outcomes should be investigated.