title: Serum vitamin D levels are positively associated with varicella zoster immunity in chronic dialysis patients.
abstract: Uremia results in a relatively immunocompromised status, and patients under chronic dialysis have an elevated risk of developing herpes zoster (HZ). We sought to investigate the relationship between vitamin D status and immunity to varicella-zoster virus (VZV). A multicenter prevalent hemodialysis cohort was assembled between 2012 and 2013. We assayed the biochemical parameters, 25-hydroxy- (25-OH-D) and 1,25-dihydroxyvitamin D, vitamin D-binding protein levels in the sera. VZV immunity was quantitated using VZV-specific glycoprotein IgG and IgM titers. Eighty-eight patients were enrolled and their sera were analyzed. Chronic hemodialysis patients with 25-OH-D < 30 ng/ml (insufficiency or deficiency) had significantly lower VZV-IgG than those with sufficient 25-OH-D (p = 0.04). This discrepancy became more prominent if active vitamin D users alone were analyzed (p = 0.01). Generalized additive modeling showed that those with 25-OH-D higher than 27.8 ng/ml or bioavailable 25-OH-D higher than 3.88 ng/ml had significantly higher VZV-IgG levels than those with lower values. Linear regression suggested that both total and bioavailable 25-OH-D were significantly associated with higher VZV-IgG levels (p = 0.003 [total] and 0.01 [bioavailable]), whereas patients with cancer had lower VZV-IgG. Vitamin D may therefore be a potentially useful choice for raising VZV immunity in chronic dialysis patients.
authors.affiliation: 1] Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital [2] Division of Nephrology, Department of Internal Medicine, Jin-Shan branch, New Taipei City [3] Graduate Institute of Toxicology, National Taiwan University, Taipei, Taiwan.
authors.forename: Chia-Ter
authors.initials: CT
authors.lastname: Chao
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Yun-Lin branch, Yun-Lin County.
authors.forename: Szu-Ying
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Hsin-Chu branch, Hsin-Chu County, Taiwan.
authors.forename: Wei-Shun
authors.initials: WS
authors.lastname: Yang
authors.affiliation: Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital.
authors.forename: Chung-Jen
authors.initials: CJ
authors.lastname: Yen
authors.affiliation: 1] Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital [2] Graduate Institute of Toxicology, National Taiwan University, Taipei, Taiwan.
authors.forename: Chih-Kang
authors.initials: CK
authors.lastname: Chiang
authors.affiliation: Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital.
authors.forename: Jenq-Wen
authors.initials: JW
authors.lastname: Huang
authors.affiliation: Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital.
authors.forename: Kuan-Yu
authors.initials: KY
authors.lastname: Hung
mesh_terms: D000368:Aged; D000914:Antibodies, Viral / Q000097:blood / Q000276:immunology; D015897:Comorbidity; D005260:Female; D006562:Herpes Zoster / Q000097:blood* / Q000209:etiology*; D014645:Herpesvirus 3, Human / Q000276:immunology*; D006728:Hormones / Q000097:blood; D006801:Humans; D016867:Immunocompromised Host; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D007075:Immunoglobulin M / Q000097:blood / Q000276:immunology; D008297:Male; D008875:Middle Aged; D008903:Minerals / Q000378:metabolism; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood*
chemical_list: D000914:Antibodies, Viral; D006728:Hormones; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D008903:Minerals; D014807:Vitamin D; C097949:1,25-dihydroxyvitamin D