TY - JOUR
T1 - Prognostic value of vitamin D level for all-cause mortality, and association with inflammatory markers, in HIV-infected persons
AU - Shepherd, Leah
AU - Souberbielle, Jean-Claude
AU - Bastard, Jean-Philippe
AU - Fellahi, Soraya
AU - Capeau, Jaqueline
AU - Reekie, Joanne
AU - Reiss, Peter
AU - Blaxhult, Anders
AU - Bickel, Markus
AU - Leen, Clifford
AU - Kirk, Ole
AU - Lundgren, Jens D
AU - Mocroft, Amanda
AU - Viard, Jean-Paul
AU - EuroSIDA in EuroCoord
N1 - © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: [email protected].
PY - 2014/7/15
Y1 - 2014/7/15
N2 - 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.
AB - 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.
KW - Adult
KW - Biological Markers
KW - Cohort Studies
KW - Disease Progression
KW - Female
KW - HIV Infections
KW - Humans
KW - Male
KW - Middle Aged
KW - Prognosis
KW - Prospective Studies
KW - Survival Analysis
KW - Vitamin D
U2 - 10.1093/infdis/jiu074
DO - 10.1093/infdis/jiu074
M3 - Journal article
C2 - 24493824
SN - 0022-1899
VL - 210
SP - 234
EP - 243
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 2
ER -
