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Low vitamin D predicted mortality in HIV
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Among patients with HIV, low vitamin D levels predicted short-term mortality, according to data from the EuroSIDA study.
“This study cannot establish a causal relationship between vitamin D and death, but indicate the potential prognostic value of vitamin D deficiency in predicting short-term all-cause mortality in [patients with HIV], and provide a testable hypothesis on the underlying mechanism,” the researchers wrote in the Journal of Infectious Diseases.
The EuroSIDA study is a prospective, observational, open cohort that included 18,295 patients with HIV across Europe. For this prospective, case-control study, the researchers selected cases and controls with plasma samples at least 6 months after the baseline plasma sample. Cases with three different outcomes were selected: AIDS (n=50), non–AIDS-defining event (n=63) and/or death (n=42). Each case was matched to a control 1:1, and the study included 250 patients. The researchers measured levels of 25-hydroxyvitamin D (25-[OH]D) in the plasma samples.
Ninety-seven patients (38.8%) had severe vitamin D deficiency, defined as a 25-(OH)D level of less than 10 ng/mL, at any time during the follow-up period. After controlling for season, ethnicity and prior AIDS status, odds of death decreased by 46% (95% CI, 2-70) among those with a twofold higher 25-(OH)D level at latest measurement. There was no association between 25-(OH)D level at baseline and death. There was no association between 25-(OH)D levels at baseline or latest measurement with AIDS or non–AIDS-defining events.
“Since vitamin D administration is easy and safe in [patients with HIV], intervention trials testing whether vitamin D supplementation can lower levels of soluble inflammatory or immune cell activation markers in HIV infection, as demonstrated in tuberculosis, are warranted, although the impact on mortality may be limited,” the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.
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