title: Vitamin D-related host genetic variants alter HIV disease progression in children.
abstract: BACKGROUND
  Vitamin D deficiency is common in HIV infection and has been associated with advanced disease. This study investigated whether vitamin D-related genetic variants were associated with disease progression in HIV-infected children.
  
  
  METHODS
  The Fok-I (C/T), Bsm-I (G/A), GC (A/C), DHCR7 (G/T) and CYP2R1 (G/A) genetic variants were detected by real-time polymerase chain reaction in HIV-infected children who participated in the Pediatric AIDS Clinical Trials Group P152 and P300 protocols, which predated the availability of effective combination antiretroviral therapy. The primary endpoints included time to progression to the first HIV-related disease endpoint (≥2 opportunistic infection, weight growth failure) or death, which constituted the progression-free survival. Analyses were performed for age>2 years and ≤2 years separately adjusting for race and treatment effect.
  
  
  RESULTS
  Of the 998 children evaluated, 139 experienced HIV disease progression. For children>2 years, rapid disease progression was associated with the DHCR7 G allele compared with the T allele (G/G vs. T/T: hazard ratio [HR]=5.0, P = 0.035; G/T vs. T/T: HR=4.5, P=0.042; G/G+G/T vs. T/T: HR=4.8, P=0.036) and the Bsm-I A allele compared with the G allele (A/G vs. G/G: HR=2.2, P=0.014 and A/G+A/A vs. G/G: HR=2.0, P=0.026). In children≤2 years, the Bsm-I A allele increased the risk of disease progression in Hispanics (A/A vs. G/A+G/G: HR=2.8, P=0.03 and A/A vs. G/G: HR=2.8, P=0.046) and whites (A/A vs. G/G: HR=6.6, P=0.025 and A/A vs. G/A+G/G: HR=3.6, P=0.038).
  
  
  CONCLUSIONS
  Vitamin D-related host genetic variants that alter the availability and activity of vitamin D are associated with risk of HIV disease progression in children and may vary by age and race.
authors.affiliation: From the *University of California, San Diego; †Rady Children's Hospital, San Diego, CA; and ‡Center for Biostatistics in AIDS Research, Harvard School of Public Health, Boston, MA.
authors.forename: Amaran
authors.initials: A
authors.lastname: Moodley
authors.forename: Min
authors.initials: M
authors.lastname: Qin
authors.forename: Kumud K
authors.initials: KK
authors.lastname: Singh
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Spector
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000235:genetics* / Q000378:metabolism*; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D044925:Oxidoreductases Acting on CH-CH Group Donors / Q000235:genetics / Q000378:metabolism; D020641:Polymorphism, Single Nucleotide; D016032:Randomized Controlled Trials as Topic; D018167:Receptors, Calcitriol / Q000235:genetics / Q000378:metabolism; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D014807:Vitamin D / Q000235:genetics* / Q000378:metabolism
chemical_list: D018167:Receptors, Calcitriol; D018894:Reverse Transcriptase Inhibitors; D014807:Vitamin D; D044925:Oxidoreductases Acting on CH-CH Group Donors; C019995:7-dehydrocholesterol reductase