Prognostic value of vitamin D level for all-cause mortality, and association with inflammatory markers, in HIV-infected persons

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Leah Shepherd
  • Jean-Claude Souberbielle
  • Jean-Philippe Bastard
  • Soraya Fellahi
  • Jaqueline Capeau
  • Joanne Reekie
  • Peter Reiss
  • Anders Blaxhult
  • Markus Bickel
  • Clifford Leen
  • Kirk, Ole
  • Lundgren, Jens
  • Amanda Mocroft
  • Jean-Paul Viard
  • EuroSIDA in EuroCoord

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.

TidsskriftThe Journal of Infectious Diseases
Udgave nummer2
Sider (fra-til)234-43
Antal sider10
StatusUdgivet - 15 jul. 2014

ID: 137199994