Relationship of vitamin D insufficiency to AIDS-associated Kaposi's sarcoma outcomes: retrospective analysis of a prospective clinical trial in Zimbabwe

• Published in: International journal of infectious diseases Vol. 24; pp. 6 - 10
• Main Authors: Erlandson, Kristine M, Gudza, Ivy, Fiorillo, Suzanne, Ndemera, Buxton, Schooley, Robert T, Gwanzura, Lovemore, Borok, Margaret, Campbell, Thomas B
• Format: Journal Article
• Language: English
• Published: Canada Elsevier Ltd 01.07.2014
• Subjects: Adult; AIDS-KS; AIDS-Related Opportunistic Infections - drug therapy; AIDS-Related Opportunistic Infections - mortality; AIDS-Related Opportunistic Infections - pathology; AIDS-Related Opportunistic Infections - virology; Anti-HIV Agents - therapeutic use; Dideoxynucleosides - therapeutic use; Disease Progression; Female; Herpesvirus 8, Human - drug effects; Herpesvirus 8, Human - growth & development; HIV; HIV-1 - drug effects; HIV-1 - growth & development; Humans; Infectious Disease; Lamivudine - therapeutic use; Male; Middle Aged; Odds Ratio; Pilot Projects; Prospective Studies; Pulmonary/Respiratory; RNA, Viral - blood; Sarcoma, Kaposi - drug therapy; Sarcoma, Kaposi - mortality; Sarcoma, Kaposi - pathology; Sarcoma, Kaposi - virology; Survival Analysis; Treatment Outcome; Vitamin D - analogs & derivatives; Vitamin D - blood; Vitamin D Deficiency - drug therapy; Vitamin D Deficiency - mortality; Vitamin D Deficiency - pathology; Vitamin D Deficiency - virology; Vitamin D insufficiency; Zidovudine - therapeutic use; Zimbabwe; HIV; Vitamin D insufficiency; AIDS-KS
• ISSN: 1201-9712; 1878-3511
• DOI: 10.1016/j.ijid.2014.02.006

Summary Objectives The prevalence of vitamin D insufficiency in Africans with AIDS-associated Kaposi sarcoma (AIDS-KS) and the role of vitamin D in AIDS-KS progression are unknown. We hypothesized that a high prevalence of vitamin D deficiency would be found in Zimbabweans with AIDS-KS and that low baseline vitamin D would correlate with progression of AIDS-KS. Methods Ninety subjects were enrolled in a prospective pilot study investigation of the effect of antiretroviral therapy in the treatment of AIDS-KS in Harare, Zimbabwe. Co-formulated abacavir, lamivudine, and zidovudine was initiated; chemotherapy was provided at the discretion of the provider. Participants were followed for 96 weeks. 25-Hydroxyvitamin D was measured in stored specimens collected at study entry. The relationship between vitamin D and clinical response was described by odds ratio and 95% confidence interval. Results Samples were available for 85 participants; 45 (53%) subjects had inadequate (<75 nmol/l) 25-hydroxyvitamin D. HIV-1 RNA was significantly higher among those with insufficient vitamin D (4.7 vs. 4.5 log, p = 0.04). Tumor response, survival, and KS-IRIS were not associated with vitamin D ( p ≥ 0.3). Conclusions Vitamin D insufficiency was common among Zimbabweans with AIDS-KS but not associated with outcomes after initiation of antiretroviral therapy.