Change in vitamin d levels occurs early after antiretroviral therapy initiation and depends on treatment regimen in resource-limited settings.
STUDY BACKGROUND:Vitamin D has wide-ranging effects on the immune system, and studies suggest that low serum vitamin D levels are associated with worse clinical outcomes in HIV. Recent studies have identified an interaction between antiretrovirals used to treat HIV and reduced serum vitamin D levels...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2014-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3994063?pdf=render |
| _version_ | 1811287761129308160 |
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| author | Fiona P Havers Barbara Detrick Sandra W Cardoso Sima Berendes Javier R Lama Patcharaphan Sugandhavesa Noluthando H Mwelase Thomas B Campbell Amita Gupta ACTG A5175 PEARLS and NWCS319 Study Teams |
| author_facet | Fiona P Havers Barbara Detrick Sandra W Cardoso Sima Berendes Javier R Lama Patcharaphan Sugandhavesa Noluthando H Mwelase Thomas B Campbell Amita Gupta ACTG A5175 PEARLS and NWCS319 Study Teams |
| author_sort | Fiona P Havers |
| collection | DOAJ |
| description | STUDY BACKGROUND:Vitamin D has wide-ranging effects on the immune system, and studies suggest that low serum vitamin D levels are associated with worse clinical outcomes in HIV. Recent studies have identified an interaction between antiretrovirals used to treat HIV and reduced serum vitamin D levels, but these studies have been done in North American and European populations. METHODS:Using a prospective cohort study design nested in a multinational clinical trial, we examined the effect of three combination antiretroviral (cART) regimens on serum vitamin D levels in 270 cART-naïve, HIV-infected adults in nine diverse countries, (Brazil, Haiti, Peru, Thailand, India, Malawi, South Africa, Zimbabwe and the United States). We evaluated the change between baseline serum vitamin D levels and vitamin D levels 24 and 48 weeks after cART initiation. RESULTS:Serum vitamin D levels decreased significantly from baseline to 24 weeks among those randomized to efavirenz/lamivudine/zidovudine (mean change: -7.94 [95% Confidence Interval (CI) -10.42, -5.54] ng/ml) and efavirenz/emtricitabine/tenofovir-DF (mean change: -6.66 [95% CI -9.40, -3.92] ng/ml) when compared to those randomized to atazanavir/emtricitabine/didanosine-EC (mean change: -2.29 [95% CI -4.83, 0.25] ng/ml). Vitamin D levels did not change significantly between week 24 and 48. Other factors that significantly affected serum vitamin D change included country (p<0.001), season (p<0.001) and baseline vitamin D level (p<0.001). CONCLUSION:Efavirenz-containing cART regimens adversely affected vitamin D levels in patients from economically, geographically and racially diverse resource-limited settings. This effect was most pronounced early after cART initiation. Research is needed to define the role of Vitamin D supplementation in HIV care. |
| first_indexed | 2024-04-13T03:24:08Z |
| format | Article |
| id | doaj.art-823efd77217f4ee4b1719112d208663b |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-13T03:24:08Z |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-823efd77217f4ee4b1719112d208663b2022-12-22T03:04:42ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0194e9516410.1371/journal.pone.0095164Change in vitamin d levels occurs early after antiretroviral therapy initiation and depends on treatment regimen in resource-limited settings.Fiona P HaversBarbara DetrickSandra W CardosoSima BerendesJavier R LamaPatcharaphan SugandhavesaNoluthando H MwelaseThomas B CampbellAmita GuptaACTG A5175 PEARLS and NWCS319 Study TeamsSTUDY BACKGROUND:Vitamin D has wide-ranging effects on the immune system, and studies suggest that low serum vitamin D levels are associated with worse clinical outcomes in HIV. Recent studies have identified an interaction between antiretrovirals used to treat HIV and reduced serum vitamin D levels, but these studies have been done in North American and European populations. METHODS:Using a prospective cohort study design nested in a multinational clinical trial, we examined the effect of three combination antiretroviral (cART) regimens on serum vitamin D levels in 270 cART-naïve, HIV-infected adults in nine diverse countries, (Brazil, Haiti, Peru, Thailand, India, Malawi, South Africa, Zimbabwe and the United States). We evaluated the change between baseline serum vitamin D levels and vitamin D levels 24 and 48 weeks after cART initiation. RESULTS:Serum vitamin D levels decreased significantly from baseline to 24 weeks among those randomized to efavirenz/lamivudine/zidovudine (mean change: -7.94 [95% Confidence Interval (CI) -10.42, -5.54] ng/ml) and efavirenz/emtricitabine/tenofovir-DF (mean change: -6.66 [95% CI -9.40, -3.92] ng/ml) when compared to those randomized to atazanavir/emtricitabine/didanosine-EC (mean change: -2.29 [95% CI -4.83, 0.25] ng/ml). Vitamin D levels did not change significantly between week 24 and 48. Other factors that significantly affected serum vitamin D change included country (p<0.001), season (p<0.001) and baseline vitamin D level (p<0.001). CONCLUSION:Efavirenz-containing cART regimens adversely affected vitamin D levels in patients from economically, geographically and racially diverse resource-limited settings. This effect was most pronounced early after cART initiation. Research is needed to define the role of Vitamin D supplementation in HIV care.http://europepmc.org/articles/PMC3994063?pdf=render |
| spellingShingle | Fiona P Havers Barbara Detrick Sandra W Cardoso Sima Berendes Javier R Lama Patcharaphan Sugandhavesa Noluthando H Mwelase Thomas B Campbell Amita Gupta ACTG A5175 PEARLS and NWCS319 Study Teams Change in vitamin d levels occurs early after antiretroviral therapy initiation and depends on treatment regimen in resource-limited settings. PLoS ONE |
| title | Change in vitamin d levels occurs early after antiretroviral therapy initiation and depends on treatment regimen in resource-limited settings. |
| title_full | Change in vitamin d levels occurs early after antiretroviral therapy initiation and depends on treatment regimen in resource-limited settings. |
| title_fullStr | Change in vitamin d levels occurs early after antiretroviral therapy initiation and depends on treatment regimen in resource-limited settings. |
| title_full_unstemmed | Change in vitamin d levels occurs early after antiretroviral therapy initiation and depends on treatment regimen in resource-limited settings. |
| title_short | Change in vitamin d levels occurs early after antiretroviral therapy initiation and depends on treatment regimen in resource-limited settings. |
| title_sort | change in vitamin d levels occurs early after antiretroviral therapy initiation and depends on treatment regimen in resource limited settings |
| url | http://europepmc.org/articles/PMC3994063?pdf=render |
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