title: Review of metabolic, immunologic, and virologic consequences of suboptimal vitamin D levels in HIV infection.
abstract: Low 25-hydroxyvitamin D levels are common in the general and HIV-infected populations alike. Defined as levels less than 30 ng/mL, suboptimal vitamin D is known to afflict over 70% of representative samples from each group in resource-rich countries with even greater prevalence in resource-poor regions of the world. In both those with and without HIV, dark skin, low vitamin D intake, exiguous exposure to sunlight, and season act as risk factors for suboptimal vitamin D levels. In those infected with HIV, antiretroviral therapy, particularly non-nucleoside reverse transcriptase inhibitors (NNRTIs), increase risk for low vitamin D as well. Furthermore, metabolic aberrations, including obesity and hyperlipidemia, and miscellaneous risk factors, such as advanced AIDS and substance abuse, have been linked to suboptimal vitamin D in those with HIV. While the skeletal and cardiovascular systems of HIV patients may be adversely impacted as a result of low levels, recent data have also linked low vitamin D to decreased CD4 counts, higher viral loads, and to critical end points including progression to AIDS events and death. More research is needed to confirm these potential consequences of low vitamin D in those with HIV and to discern the benefits of routine screening for and treatment of low vitamin D in this population.
authors.affiliation: School of Medicine, Department of Medicine, Division of Infectious Diseases, University of Louisville, Louisville, Kentucky 40292, USA. atgrif01@louisville.edu
authors.forename: Allen T
authors.initials: AT
authors.lastname: Griffin
authors.forename: Forest W
authors.initials: FW
authors.lastname: Arnold
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000453:epidemiology* / Q000276:immunology; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D018791:CD4 Lymphocyte Count; D002318:Cardiovascular Diseases / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D006679:HIV Seropositivity / Q000150:complications / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D019562:Viral Load; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000150:complications / Q000178:diet therapy / Q000453:epidemiology*; D014815:Vitamins
chemical_list: D014815:Vitamins; D014807:Vitamin D; C104450:25-hydroxyvitamin D