Alison G Abraham1,2, Long Zhang1, Keri Calkins1, Adrienne Tin1, Andrew Hoofnagle3, Frank J Palella4, Michelle M Estrella5,6, Lisa P Jacobson1, Mallory D Witt7,8, Lawrence A Kingsley9, Todd T Brown10. 1. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. 2. Department of Ophthalmology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA. 3. Department of Laboratory Medicine, University of Washington, Seattle, Washington. 4. Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, Illinois. 5. Department of Medicine, UCSF School of Medicine, San Francisco. 6. San Francisco VA Medical Center, San Francisco. 7. Division of Infectious Diseases, Harbor-UCLA Medical Center, Los Angeles. 8. Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, California. 9. Infectious Diseases and Microbiology Department, University of Pittsburgh, Pittsburgh, Pennsylvania. 10. Department of Medicine.
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)2D 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)2D 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)2D 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)2D 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)2D levels as an indicator of immune response dysregulation could be further explored.
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)2D 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)2D 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)2D 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)2D 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)2D levels as an indicator of immune response dysregulation could be further explored.
Authors: P M Tarwater; J B Margolick; J Jin; J P Phair; R Detels; C Rinaldo; J Giorgi; A Muñoz Journal: J Acquir Immune Defic Syndr Date: 2001-06-01 Impact factor: 3.731
Authors: Rainer Weber; Caroline A Sabin; Nina Friis-Møller; Peter Reiss; Wafaa M El-Sadr; Ole Kirk; Francois Dabis; Matthew G Law; Christian Pradier; Stephane De Wit; Börje Akerlund; Gonzalo Calvo; Antonella d'Arminio Monforte; Martin Rickenbach; Bruno Ledergerber; Andrew N Phillips; Jens D Lundgren Journal: Arch Intern Med Date: 2006 Aug 14-28
Authors: Mariam Aziz; Britt Livak; Jane Burke-Miller; Audrey L French; Marshall J Glesby; Anjali Sharma; Mary Young; Maria C Villacres; Phyllis C Tien; Elizabeth T Golub; Mardge H Cohen; Oluwatoyin M Adeyemi Journal: AIDS Date: 2013-02-20 Impact factor: 4.177
Authors: Peter W Hunt; Steven G Deeks; Benigno Rodriguez; Hernan Valdez; Starley B Shade; Donald I Abrams; Mari M Kitahata; Melissa Krone; Torsten B Neilands; Richard J Brand; Michael M Lederman; Jeffrey N Martin Journal: AIDS Date: 2003-09-05 Impact factor: 4.177
Authors: Jason V Baker; Grace Peng; Joshua Rapkin; Donald I Abrams; Michael J Silverberg; Rodger D MacArthur; Winston P Cavert; W Keith Henry; James D Neaton Journal: AIDS Date: 2008-04-23 Impact factor: 4.177