Vitamin-D deficiency impairs CD4þT-cell count recovery rate in HIV-positive adults on highly active antiretroviral therapy: Q9 A longitudinal study
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Date
2015
Journal Title
Journal ISSN
Volume Title
Publisher
Clinical Nutrition
Abstract
We implemented a prospective study among human immunodeficiency virus (HIV)-
positive adults to examine the association between vitamin-D deficiency (VDD) and insufficiency (VDI)
vs sufficiency (VDS) and CD4þT-cell improvement over 18 months of highly active antiretroviral therapy
(HAART).
Methods: We used data from a randomized placebo-controlled micronutrient trial with 25-hydroxy
vitamin-D (25(OH)D) measured at enrollment in 398 adults. CD4þT-cell count was measured repeatedly
at months 0, 3, 6, 12 and 18. Linear mixed models quantified the vitamin-D-related differences in
CD4þT-cell count and associated 99% confidence intervals at baseline and respective follow-up intervals.
Results: At baseline 23%, 60% and 17% of participants were VDS, VDI and VDD, respectively. Absolute
CD4þT- cell counts recovered during follow-up were persistently lower for baseline VDD and VDI
relative to VDS participants. The greatest deficit in absolute CD4þT-cells recovered occurred in VDD vs
VDS participants with estimates ranging from a minimum deficit of 26 cells/ml (99% CI: 77, 26) to a
maximum deficit of 65 cells/ml (99% CI: 125, 5.5) during follow-up. This VDD-associated lower
absolute CD4þT-cell gain was strongest among patients 35 years old or younger and among participants
with a baseline body mass index of less than 25 kg/m2.
Conclusions: VDD is associated with lower absolute CD4þT-cell count recovery in HIV-positive patients
on HAART. Vitamin-D supplementation may improve CD4þT-cell recovery during HAART. However,
future intervention studies are needed to definitively evaluate the effectiveness of this vitamin as an
adjunct therapy during HAART.
Description
Keywords
Vitamin-D, HIV, CD4þ, T-cell count, Antiretroviral therapy, Immune recovery
Citation
Ezeamama AE, et al., Vitamin-D deficiency impairs CD4þT-cell count recovery rate in HIV-positive adults on highly active antiretroviral therapy: A longitudinal study, Clinical Nutrition (2015), http://dx.doi.org/10.1016/j.clnu.2015.08.007