Viard, JP and Souberbielle, JC and Kirk, O and Reekie, J and Knysz, B and Losso, M and Gatell, J and Pedersen, C and Bogner, JR and Lundgren, JD and Mocroft, A and EuroSIDA Study Grp, (2011) Vitamin D and clinical disease progression in HIV infection: results from the EuroSIDA study. AIDS , 25 (10) 1305 - 1315. 10.1097/QAD.0b013e328347f6f7.
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Background: We examined the association between vitamin D [ 25(OH) D] level and disease progression in HIV infection.Methods: Within the EuroSIDA study, 2000 persons were randomly selected for 25(OH) D measurement in stored plasma samples closest to study entry. 25(OH) D results were stratified into tertiles. Factors associated with 25(OH) D levels and associations of 25(OH) levels with subsequent risk of all-cause mortality, AIDS and non-AIDS events were analyzed.Results: Of 1985 persons with 25(OH) D levels available, 23.7% had 25(OH) D below 10, 65.3% between 10 and 30, and 11% above 30 ng/ml. At the time of 25(OH) D measurement, older persons, persons of black ethnic origin, living outside Southern Europe/Argentina, sampled during winter, and infected with HIV through nonhomo-sexual exposure were at higher odds of having low 25(OH) D levels, whereas persons receiving protease inhibitors were at lower odds. Compared to those in the lowest 25(OH) D tertile (<12 ng/ml), those in the middle (12-20) and higher (>20) tertiles had a significantly lower risk of clinical progression during subsequent follow-up. Adjusted incidence rate ratios for all-cause mortality were 0.68 (95% CI 0.47-0.99, P = 0.045) and 0.56 (95% CI 0.37-0.83, P = 0.0039), and for AIDS events were 0.58 (95% CI 0.39-0.87, P = 0.0086) and 0.61 (95% CI 0.40-0.93, P = 0.020), for the middle and higher tertiles, respectively. There was a similar, nonsignificant reduced incidence of non-AIDS events in the middle and higher tertiles.Conclusion: 25(OH) D deficiency was frequent in HIV-infected persons (83% on combined antiretroviral therapy), and was independently associated with a higher risk of mortality and AIDS events. Causality relationships should be examined, because of potential public health consequences. (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins
|Title:||Vitamin D and clinical disease progression in HIV infection: results from the EuroSIDA study|
|Keywords:||AIDS-defining events, all-cause mortality, HIV infection, vitamin D, D DEFICIENCY, ANTIRETROVIRAL THERAPY, CARDIOVASCULAR MORTALITY, GENERAL-POPULATION, HEART-FAILURE, ALL-CAUSE, ASSOCIATION, RISK, 25-HYDROXYVITAMIN-D, CANCER|
|UCL classification:||UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health Care|
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