title: Vitamin D is linked to carotid intima-media thickness and immune reconstitution in HIV-positive individuals.
abstract: BACKGROUND
  Patients with HIV infection are at increased risk of cardiovascular disease (CVD). Vitamin D insufficiency has been associated with increased CVD risk in non-HIV populations. This study sought to determine the relationship between vitamin D status and markers of CVD and HIV-related factors in HIV-positive patients.
  
  
  METHODS
  Patients with HIV infection on antiretroviral therapy and healthy controls were prospectively enrolled. Fasting lipids, glucose, insulin, inflammatory markers (soluble tumour necrosis factor-α receptor I, interleukin-6 and high-sensitivity C-reactive protein) and endothelial markers (soluble intercellular adhesion molecule-1 and soluble vascular cell adhesion molecule-1) were measured. Fasting 25-hydroxyvitamin D (25(OH)D) was measured from stored serum samples. The internal carotid artery and common carotid artery (CCA) intima-media thickness (IMT) were measured in a subset of HIV-positive patients. Baseline cross-sectional data were analysed.
  
  
  RESULTS
  A total of 149 HIV-positive patients (56 with carotid IMT) and 34 controls were included. Controls had higher adjusted mean 25(OH)D levels than HIV-positive patients (P=0.02). In multivariable linear regression among the HIV-positive patients, 25(OH)D was positively associated with CD4(+) T-cell restoration after antiretroviral therapy (ΔCD4 = current - nadir CD4(+) T-cell; P<0.01), but was not associated with inflammatory or endothelial markers. In multivariable logistic regression, odds of having CCA IMT above the median were more than 10× higher in those with lower 25(OH)D levels (OR=10.62, 95% CI 1.37-82.34; P<0.01).
  
  
  CONCLUSIONS
  Vitamin D status in HIV-positive patients was positively associated with improved immune restoration after antiretroviral therapy and negatively associated with CCA IMT. These findings suggest that vitamin D may play a role in HIV-related CVD and in immune reconstitution after antiretroviral therapy.
authors.affiliation: Emory University School of Medicine, Atlanta, GA, USA. across3@emory.edu
authors.forename: Allison C
authors.initials: AC
authors.lastname: Ross
authors.forename: Suzanne
authors.initials: S
authors.lastname: Judd
authors.forename: Meena
authors.initials: M
authors.lastname: Kumari
authors.forename: Corrilynn
authors.initials: C
authors.lastname: Hileman
authors.forename: Norma
authors.initials: N
authors.lastname: Storer
authors.forename: Danielle
authors.initials: D
authors.lastname: Labbato
authors.forename: Vin
authors.initials: V
authors.lastname: Tangpricha
authors.forename: Grace A
authors.initials: GA
authors.lastname: McComsey
mesh_terms: D015652:25-Hydroxyvitamin D 2 / Q000097:blood; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D002340:Carotid Artery Diseases / Q000150:complications* / Q000473:pathology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006679:HIV Seropositivity / Q000150:complications / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D017540:Tunica Media / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D014807:Vitamin D / Q000097:blood*
chemical_list: D019380:Anti-HIV Agents; D014807:Vitamin D; D015652:25-Hydroxyvitamin D 2