Associations between 25-hydroxyvitamin D and immunologic, metabolic, inflammatory markers in treatment-naive HIV-infected persons: the ANRS CO9 «COPANA» cohort study.
OBJECTIVE
Low 25(OH)D has been associated with dyslipidemia, insulin resistance and inflammation in both general and HIV-infected (mostly treated) populations. We investigated these associations in antiretroviral-naïve HIV-infected persons.


METHODS
We measured plasma 25(OH)D, metabolic, immunologic and inflammatory markers in 355 persons (204 Whites, 151 Blacks) at enrollment in the ANRS COPANA cohort.


METHODS
25(OH)D levels were categorized <10 ng/mL (severe deficiency) and <20 ng/mL (deficiency). Statistical analyses were adjusted for sampling season, ethnicity and the interaction between season and ethnicity.


RESULTS
25(OH)D insufficiency (<30 ng/mL), deficiency (<20 ng/mL) and severe deficiency (<10 ng/mL) were highly prevalent (93%, 67% and 24% of patients, respectively). Blacks had significantly lower 25(OH)D than Whites (median: 13 vs. 17 ng/mL, P<0.001), with markedly less pronounced seasonal variation. Smoking and drinking alcohol were associated with having a 25 OHD level<10 ng/mL. In patients with 25(OH)D<10 ng/mL, the proportion of persons with a CD4 count<100/mm(3) was higher than in patients with 25(OH)D≥10 ng/mL (18.8% vs. 10.7%, P = 0.04). Persons with 25 OHD<10 ng/mL had higher levels of hsCRP (1.60 mg/L [IQR: 0.59-5.76] vs. 1.27 mg/L [0.58-3,39], P = 0.03) and resistin (16.81 ng/L [IQR: 13.82-25.74] vs. 11.56 ng/L [IQR: 8.87-20.46], P = 0.02), and, among Blacks only, sTNFR2 (2.92 ng/mL [2.31-4.13] vs. 2.67 ng/mL, [1.90-3.23], P = 0.04). The strength and significance of the association between CD4<100/mm(3) and 25 OHD<10 ng/mL were reduced after adjustment on sTNFR1, sTNFR2, and hsCRP levels. In multivariate analysis, a CD4 count <100/mm(3), resistin concentration and smoking were independently associated with 25(OH)D<10 ng/mL.


CONCLUSIONS
Severe vitamin D deficiency was associated with low CD4 counts and increased markers of inflammation in ARV-naïve HIV-infected persons.
Institut National de la Santé et de la Recherche Médicale (INSERM), unité mixte de recherche et de service (UMRS) 1018, équipe « Epidémiologie du VIH et des infections sexuellement transmissibles », centre de recherche en épidémiologie et santé des populations (CESP)-INSERM U1018, Le Kremlin-Bicêtre, France ; Université Paris-Sud, Le Kremlin-Bicêtre, France.
Camille
C
Legeai
Corinne
C
Vigouroux
Jean-Claude
JC
Souberbielle
Olivier
O
Bouchaud
Faroudy
F
Boufassa
Jean-Philippe
JP
Bastard
Robert
R
Carlier
Jacqueline
J
Capeau
Cécile
C
Goujard
Laurence
L
Meyer
Jean-Paul
JP
Viard
D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D044383:Black People; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D005260:Female; D005602:France; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000276:immunology* / Q000378:metabolism*; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000276:immunology; D008137:Longitudinal Studies; D008297:Male; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications; D044465:White People
D044966:Anti-Retroviral Agents; D015415:Biomarkers; D014807:Vitamin D; C104450:25-hydroxyvitamin D