title: High-dose vitamin D3 reduces deficiency caused by low UVB exposure and limits HIV-1 replication in urban Southern Africans.
abstract: Cape Town, South Africa, has a seasonal pattern of UVB radiation and a predominantly dark-skinned urban population who suffer high HIV-1 prevalence. This coexistent environmental and phenotypic scenario puts residents at risk for vitamin D deficiency, which may potentiate HIV-1 disease progression. We conducted a longitudinal study in two ethnically distinct groups of healthy young adults in Cape Town, supplemented with vitamin D3 in winter, to determine whether vitamin D status modifies the response to HIV-1 infection and to identify the major determinants of vitamin D status (UVB exposure, diet, pigmentation, and genetics). Vitamin D deficiency was observed in the majority of subjects in winter and in a proportion of individuals in summer, was highly correlated with UVB exposure, and was associated with greater HIV-1 replication in peripheral blood cells. High-dosage oral vitamin D3 supplementation attenuated HIV-1 replication, increased circulating leukocytes, and reversed winter-associated anemia. Vitamin D3 therefore presents as a low-cost supplementation to improve HIV-associated immunity.
authors.affiliation: Clinical Infectious Diseases Research Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, South Africa;
authors.forename: Anna K
authors.identifier: http://orcid.org/0000-0002-7086-2621
authors.initials: AK
authors.lastname: Coussens
authors.affiliation: Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa;
authors.forename: Celeste E
authors.initials: CE
authors.lastname: Naude
authors.affiliation: Clinical Infectious Diseases Research Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, South Africa;
authors.forename: Rene
authors.initials: R
authors.lastname: Goliath
authors.affiliation: Department of Geography, The Pennsylvania State University, University Park, PA 16802; Department of Anthropology, The Pennsylvania State University, University Park, PA 16802; Stellenbosch Institute for Advanced Studies, Stellenbosch 7600, South Africa;
authors.forename: George
authors.initials: G
authors.lastname: Chaplin
authors.affiliation: Clinical Infectious Diseases Research Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Observatory 7925, South Africa; The Francis Crick Institute, Mill Hill Laboratory, London NW7 1AA, United Kingdom; Department of Medicine, Imperial College London, London W2 1PG, United Kingdom.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Wilkinson
authors.affiliation: Department of Anthropology, The Pennsylvania State University, University Park, PA 16802; Stellenbosch Institute for Advanced Studies, Stellenbosch 7600, South Africa; ngj2@psu.edu.
authors.forename: Nina G
authors.initials: NG
authors.lastname: Jablonski
mesh_terms: D000328:Adult; D000353:Africa, Southern / Q000453:epidemiology; D002762:Cholecalciferol / Q000494:pharmacology*; D004305:Dose-Response Relationship, Drug; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000821:virology*; D015528:HIV Seroprevalence; D015497:HIV-1 / Q000502:physiology*; D006801:Humans; D008137:Longitudinal Studies; D020641:Polymorphism, Single Nucleotide; D012621:Seasons; D014466:Ultraviolet Rays; D014505:Urban Population; D014779:Virus Replication / Q000187:drug effects*; D014808:Vitamin D Deficiency / Q000150:complications / Q000453:epidemiology; D055815:Young Adult
chemical_list: D002762:Cholecalciferol
keywords: infectious disease; nutrition; pigmentation; polymorphism; seasonal variation