Relationship of vitamin D insufficiency to AIDS-associated Kaposi's sarcoma outcomes: retrospective analysis of a prospective clinical trial in Zimbabwe.
OBJECTIVE
The prevalence of vitamin D insufficiency in Africans with AIDS-associated Kaposi sarcoma (AIDS-KS) and the role of vitamin D in AIDS-KS progression are unknown. We hypothesized that a high prevalence of vitamin D deficiency would be found in Zimbabweans with AIDS-KS and that low baseline vitamin D would correlate with progression of AIDS-KS.


METHODS
Ninety subjects were enrolled in a prospective pilot study investigation of the effect of antiretroviral therapy in the treatment of AIDS-KS in Harare, Zimbabwe. Co-formulated abacavir, lamivudine, and zidovudine was initiated; chemotherapy was provided at the discretion of the provider. Participants were followed for 96 weeks. 25-Hydroxyvitamin D was measured in stored specimens collected at study entry. The relationship between vitamin D and clinical response was described by odds ratio and 95% confidence interval.


RESULTS
Samples were available for 85 participants; 45 (53%) subjects had inadequate (<75 nmol/l) 25-hydroxyvitamin D. HIV-1 RNA was significantly higher among those with insufficient vitamin D (4.7 vs. 4.5 log, p = 0.04). Tumor response, survival, and KS-IRIS were not associated with vitamin D (p ≥ 0.3).


CONCLUSIONS
Vitamin D insufficiency was common among Zimbabweans with AIDS-KS but not associated with outcomes after initiation of antiretroviral therapy.
Department of Medicine, Division of Infectious Diseases, University of Colorado Denver, 12700 E. 19(th) Avenue, Mail Stop B168, Aurora, CO 80045, USA. Electronic address: Kristine.Erlandson@ucdenver.edu.
Kristine M
KM
Erlandson
Department of Medicine, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe.
Ivy
I
Gudza
Department of Medicine, Division of Infectious Diseases, University of Colorado Denver, 12700 E. 19(th) Avenue, Mail Stop B168, Aurora, CO 80045, USA.
Suzanne
S
Fiorillo
Department of Medicine, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe.
Buxton
B
Ndemera
Department of Medicine, Division of Infectious Diseases, University of California San Diego, La Jolla, California, USA.
Robert T
RT
Schooley
Department of Medical Laboratory Sciences, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe.
Lovemore
L
Gwanzura
Department of Medicine, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe.
Margaret
M
Borok
Department of Medicine, Division of Infectious Diseases, University of Colorado Denver, 12700 E. 19(th) Avenue, Mail Stop B168, Aurora, CO 80045, USA.
Thomas B
TB
Campbell
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000821:virology; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D015224:Dideoxynucleosides / Q000627:therapeutic use; D018450:Disease Progression; D005260:Female; D015497:HIV-1 / Q000187:drug effects / Q000254:growth & development; D019288:Herpesvirus 8, Human / Q000187:drug effects / Q000254:growth & development; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010865:Pilot Projects; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood*; D012514:Sarcoma, Kaposi / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000821:virology; D016019:Survival Analysis; D016896:Treatment Outcome; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000821:virology; D015215:Zidovudine / Q000627:therapeutic use; D015030:Zimbabwe; D000099227:Abacavir
D019380:Anti-HIV Agents; D015224:Dideoxynucleosides; D019259:Lamivudine; D012367:RNA, Viral; D014807:Vitamin D; D015215:Zidovudine; D000099227:Abacavir; C104450:25-hydroxyvitamin D
AIDS-KS; HIV; Vitamin D insufficiency