NATAP: Vit D Linked to Heart Disease & CD4 in HIV+

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On May 19, 2011, at 7:29 AM, Jules Levin wrote:Begin forwarded message:Vitamin D is linked to carotid intima-media thickness and immune reconstitution in HIV-positive individuals: 'and to CD4 change after starting ART' - pdf attachedAntiviral Therapy May 2011 in press"These data suggest that a high 25(OH)D level may be protective against CVD development in HIV-positive people.....these results suggest that using vitamin D supplementation with ART, especially at the time of ART initiation, may provide an additional way to enhance CD4+ T-cell counts.....we showed that 25(OH)D levels were associated with changes in CD4+ T-cell (current minus nadir CD4+ T-cell count) after starting ART....In addition, vitamin D optimization could also have implications for improving CD4+ T-cell count in people already virologically suppressed on therapy......Lastly, when mean 25(OH)D concentrations in the HIV-positive groups were compared with the healthy control group, levels were statistically lower in the HIV-positive group.....study suggest that vitamin D insufficiency is a modifiable risk that deserves further attention.""To our knowledge, this is the first study to investigate the relationship of vitamin D to CVD risk in the HIV-infected population. Our results show that vitamin D is associated with immune restoration, as well as with carotid IMT, which supports the fact that vitamin D may play a role in both HIV-related CVD and immune reconstitution. These results are novel and not only may offer insight into the pathogenesis of CVD in this population, but may offer a potential safe mechanism for decelerating its development. Likewise, these results suggest that using vitamin D supplementation with ART, especially at the time of ART initiation, may provide an additional way to enhance CD4+ T-cell counts. A randomized placebo-controlled interventional trial is crucial to determine what effect vitamin D may have on surrogate markers of CVD, as well as on immune function and reconstitution, and to determine what vitamin D level is optimal in HIV-positive patients.""In the HIV-positive group, ΔCD4 was positively associated with 25(OH)D. For each increase in standard deviation in 25(OH)D, ΔCD4 rose by 0.23 standard deviation..... we showed that 25(OH)D levels were associated with changes in CD4+ T-cell (current minus nadir CD4+ T-cell count) after starting ART. These results suggest that vitamin D status may play a role in immune function and/or immune restoration after a person is started on ART.""this study was primarily explorative, as no studies have previously evaluated vitamin D, CVD and HIV-related factors in this population, and provides a substrate for larger prospective longitudinal studies to confirm and further define these relationships." C Ross1,2,*, Suzanne Judd3, Meena Kumari1, Corrilynn Hileman4,5, Norma Storer4, le Labbato4, Vin Tangpricha1, Grace A McComsey41Emory University School of Medicine, Atlanta, GA, USA2Children’s Healthcare of Atlanta, Atlanta, GA, USA3University of Alabama at Birmingham, Birmingham, AL, USA4University Hospitals Case Medical Center and Case Western Reserve University, Cleveland, OH, USA5MetroHealth Medical Center, Cleveland, OH, USA*Corresponding author e-mail: across3@...= <Antiviral Therapy_vit D_Ross.pdf>