title: Vitamin D supplementation is associated with reduced immune activation levels in HIV-1-infected patients on suppressive antiretroviral therapy.
abstract: BACKGROUND
  A majority of HIV-1-infected patients present a severe deficit in vitamin D, which predicts short-term mortality. Vitamin D is a naturally synthesized hormone, with important immunomodulatory functions. In the general population, its deficit has been associated with increased markers of inflammation. Vitamin D deficit may therefore play a role in the establishment of elevated systemic immune activation, which persists despite suppressive antiretroviral therapy (ART) in HIV-infected patients, and is predictive of disease progression; and vitamin D supplementation may be beneficial in this context.
  
  
  METHODS
  We performed both a cross-sectional study (vitamin D deficit versus normal level) and a longitudinal study (upon vitamin D supplementation for 6 to 12 months) of HIV-1-infected patients receiving suppressive ART. The primary outcome measure was the percentage of activated memory CD8(+) T cells in blood, which is a robust marker associated with disease progression. Secondary outcomes included general T-lymphocyte and B-lymphocyte phenotype.
  
  
  RESULTS
  Although vitamin D deficiency had no influence on T-cell and B-cell subset distribution, we found an association between vitamin D and immune activation levels in HIV-1-infected patients. Vitamin D supplementation in vitamin D-deficient patients resulted in reduced immune activation levels.
  
  
  CONCLUSIONS
  The present data support the rationale of vitamin D supplementation in the routine clinical management of HIV-1-infected patients, in order to decrease immune activation levels and possibly improve long-term survival.
authors.affiliation: aSorbonne Universités, UPMC Univ Paris, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris) bINSERM, U1135, CIMI-Paris cSorbonne université, UPMC Univ Paris 06, UMR_S 1136 Pierre Louis Institute of Epidemiology and Public Health dINSERM, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique eAP-HP, Groupe hospitalier Pitié-Salpêtrière, Service des Maladies Infectieuses et Tropicales fAP-HP, Hôtel-Dieu, Centre de Diagnostic et de Thérapeutique gCochin Hospital, Infectious Pathology Unit, France and Paris Descartes University, Infectious Pathology Unit hEA 7327 Université Paris-Descartes, Sorbonne Paris Cité, Paris, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Fabre-Mersseman
authors.forename: Roland
authors.initials: R
authors.lastname: Tubiana
authors.forename: Laura
authors.initials: L
authors.lastname: Papagno
authors.forename: Charles
authors.initials: C
authors.lastname: Bayard
authors.forename: Olivia
authors.initials: O
authors.lastname: Briceno
authors.forename: Solène
authors.initials: S
authors.lastname: Fastenackels
authors.forename: Yasmine
authors.initials: Y
authors.lastname: Dudoit
authors.forename: Hafeda
authors.initials: H
authors.lastname: Rostane
authors.forename: Dominique
authors.initials: D
authors.lastname: Salmon
authors.forename: Dominique
authors.initials: D
authors.lastname: Costagliola
authors.forename: Fabienne
authors.initials: F
authors.lastname: Caby
authors.forename: Delphine
authors.initials: D
authors.lastname: Sauce
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Viard
authors.forename: Victor
authors.initials: V
authors.lastname: Appay
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000008:administration & dosage*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D001402:B-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology* / Q000473:pathology / Q000821:virology; D015497:HIV-1 / Q000302:isolation & purification; D006801:Humans; D016130:Immunophenotyping; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014807:Vitamin D / Q000008:administration & dosage*
chemical_list: D044966:Anti-Retroviral Agents; D007166:Immunosuppressive Agents; D014807:Vitamin D