Vitamin D status and immune function reconstitution in HIV-infected men initiating therapy

Alison G. Abraham*, Long Zhang, Keri Calkins, Adrienne Tin, Andrew Hoofnagle, Frank J. Palella, Michelle M. Estrella, Lisa P. Jacobson, Mallory D. Witt, Lawrence A. Kingsley, Todd T. Brown

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Objective: Despite effective antiretroviral therapy (HAART) and durable viral suppression, many HIV-infected individuals still do not achieve CD4+cell count (CD4 +) normalization. Vitamin D has immunoregulatory functions, including inducing the development of T cells and higher levels may improve CD4+rebound. Design: Longitudinal study of men from the Multicenter AIDS Cohort Study who virally suppressed following HAART initiation and had pre-HAART and post-HAART 25(OH)D and 1,25(OH) 2 D measurements and repeated measures of CD4 +. Methods: CD4+rebound was modeled using a nonlinear mixed effects model. We estimated the adjusted effect (adjusted for pre-HAART antiretroviral exposure, black race, age and CD4+at HAART initiation) of pre-HAART and post-HAART vitamin D metabolite levels on the rate of CD4+increase and final CD4+plateau. Results: Among the 263 HIV-infected HAART initiators with pre-HAART vitamin D measurements, a 1-SD higher pre-HAART 25(OH) 2 D level was associated with a 9% faster rate of rise (P = 0.02) but no gain in final CD4+plateau. In contrast, a 1-SD higher 1,25(OH) 2 D level was associated with a 43-cell lower final CD4+(P = 0.04). Among 560 men with post-HAART measurements, findings were similar to those for pre-HAART 25(OH) 2 D with 1-SD higher level associated with faster rate of rise but no improvement in final CD4 +. Conclusion: We found no evidence that higher vitamin D metabolite levels pre-HAART or post-HAART are associated with better CD4+outcomes among HIV-infected HAART initiators. However, the value of pre-HAART 1,25(OH) 2 D levels as an indicator of immune response dysregulation could be further explored.

Original languageEnglish (US)
Pages (from-to)1069-1076
Number of pages8
JournalAIDS
Volume32
Issue number8
DOIs
StatePublished - May 15 2018

Keywords

  • HIV infection
  • Vitamin D
  • immune reconstitution

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

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    Abraham, A. G., Zhang, L., Calkins, K., Tin, A., Hoofnagle, A., Palella, F. J., Estrella, M. M., Jacobson, L. P., Witt, M. D., Kingsley, L. A., & Brown, T. T. (2018). Vitamin D status and immune function reconstitution in HIV-infected men initiating therapy. AIDS, 32(8), 1069-1076. https://doi.org/10.1097/QAD.0000000000001782