25-Hydroxyvitamin D insufficiency and deficiency is associated with HIV disease progression and viro disease progression and virological failure post-antiretroviral therapy initiation in diverse multinational settings

Topic:

HIV Prevention

Authors:

Havers F, Smeaton L, Gupte N, Detrick B, Bollinger RC, Hakim J, Kumarasamy N, Andrade A, Christian P, Lama JR, Campbell TB, Gupta A; ACTG PEARLS; NWCS 319Study Teams

External Link:

Link to article

BACKGROUND:

Low 25-hydroxyvitamin D (25(OH)D) has been associated with increased HIV mortality, but prospective studies assessing treatment outcomes after combination antiretroviral therapy (cART) initiation in resource-limited settings are lacking.

METHODS:

A case-cohort study (N = 411) was nested within a randomized cART trial of 1571 cART-naive adults in 8 resource-limited settings and the United States. The primary outcome (WHO stage 3/4 disease or death within 96 weeks of cART initiation) was met by 192 cases, and 152 and 29 cases met secondary outcomes of virologic and immunologic failure. We studied prevalence and risk factors for baseline low 25(OH)D (<32 ng/mL) and examined associated outcomes using proportional hazard models.

RESULTS:

Low 25(OH)D prevalence was 49% and ranged from 27% in Brazil to 78% in Thailand. Low 25(OH)D was associated with high body mass index (BMI), winter/spring season, country-race group, and lower viral load. Baseline low 25(OH)D was associated with increased risk of human immunodeficiency virus (HIV) progression and death (adjusted hazard ratio (aHR) 2.13; 95% confidence interval [CI], 1.09-4.18) and virologic failure (aHR 2.42; 95% CI, 1.33-4.41).

CONCLUSIONS:

Low 25(OH)D is common in diverse HIV-infected populations and is an independent risk factor for clinical and virologic failure. Studies examining the potential benefit of vitamin D supplementation among HIV patients initiating cART are warranted.

J Infect Dis. 2014 Jul 15;210(2):244-53. doi: 10.1093/infdis/jiu259. Epub 2014 May 5. PubMed PMID:24799602; PubMed Central PMCID: PMC4141201

Categories

CRS
Topics

Clinical Trials

A5308: A Prospective, Single-Arm, Open-Label Study to...

This study is being done with people who are infected with HIV, but do not show any signs of having HIV. They are also feeling...

Read More

NWCS 445: Novel Biomarkers to Shorten TB Treatment

Objectives: Primary: To develop a highly predictive algorithm that identifies TB patients who will be cured by treatment...

Read More

P1077BF: Breastfeeding Version of the PROMISE Study...

1077BF is a randomized strategy trial, which is part of the PROMISE studies (1077BF, 1077FF, P1084s, and 1077HS). The Promoting...

Read More

A5128: Consent for Use of Stored Patient Specimens for...

The purpose of this study is to obtain informed consent to use stored human biological materials (HBM) (e.g., blood and other...

Read More

A5300/P2003: PHOENIx Feasibility Study

Study of MDR TB Cases and Their Household Contacts: Operational Feasibility to Inform PHOENIx Trial Design

Read More