Vitamin D is linked to carotid intima-media thickness and immune reconstitution in HIV-positive individuals.

Academic Article

Abstract

  • BACKGROUND: Patients with HIV infection are at increased risk of cardiovascular disease (CVD). Vitamin D insufficiency has been associated with increased CVD risk in non-HIV populations. This study sought to determine the relationship between vitamin D status and markers of CVD and HIV-related factors in HIV-positive patients. METHODS: Patients with HIV infection on antiretroviral therapy and healthy controls were prospectively enrolled. Fasting lipids, glucose, insulin, inflammatory markers (soluble tumour necrosis factor-α receptor I, interleukin-6 and high-sensitivity C-reactive protein) and endothelial markers (soluble intercellular adhesion molecule-1 and soluble vascular cell adhesion molecule-1) were measured. Fasting 25-hydroxyvitamin D (25(OH)D) was measured from stored serum samples. The internal carotid artery and common carotid artery (CCA) intima-media thickness (IMT) were measured in a subset of HIV-positive patients. Baseline cross-sectional data were analysed. RESULTS: A total of 149 HIV-positive patients (56 with carotid IMT) and 34 controls were included. Controls had higher adjusted mean 25(OH)D levels than HIV-positive patients (P=0.02). In multivariable linear regression among the HIV-positive patients, 25(OH)D was positively associated with CD4(+) T-cell restoration after antiretroviral therapy (ΔCD4 = current - nadir CD4(+) T-cell; P<0.01), but was not associated with inflammatory or endothelial markers. In multivariable logistic regression, odds of having CCA IMT above the median were more than 10× higher in those with lower 25(OH)D levels (OR=10.62, 95% CI 1.37-82.34; P<0.01). CONCLUSIONS: Vitamin D status in HIV-positive patients was positively associated with improved immune restoration after antiretroviral therapy and negatively associated with CCA IMT. These findings suggest that vitamin D may play a role in HIV-related CVD and in immune reconstitution after antiretroviral therapy.
  • Authors

    Published In

  • Antiviral Therapy  Journal
  • Keywords

  • 25-Hydroxyvitamin D 2, Adult, Anti-HIV Agents, CD4-Positive T-Lymphocytes, Carotid Artery Diseases, Carotid Artery, Common, Female, HIV Seropositivity, Humans, Male, Middle Aged, Tunica Intima, Tunica Media, Ultrasonography, Vitamin D
  • Digital Object Identifier (doi)

    Author List

  • Ross AC; Judd S; Kumari M; Hileman C; Storer N; Labbato D; Tangpricha V; McComsey GA
  • Start Page

  • 555
  • End Page

  • 563
  • Volume

  • 16
  • Issue

  • 4