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Vitamin D insufficiency associated with HIV progression


The Journal of Infectious Diseases reported findings from the PEARLS trial of HIV-positive men and women undergoing antiretroviral treatment, which reveal a protective effect for higher vitamin D levels against disease progression and premature death.

The current study compared participants who developed a World Health Organization classified stage 3 or 4 event (defined by advanced or severe symptoms) or death to those who did not develop this outcome. Low serum 25-hydroxyvitamin D [25(OH)D] levels, defined as less than 32 nanograms per milliliter (ng/mL), were found in an average of 49% of the participants. Subjects with low vitamin D had more than double the adjusted risk of experiencing a stage 3 or 4 disease event or death by 96 weeks than those with sufficient vitamin D levels. Of the subjects who experienced this outcome, 59% had low vitamin D levels, and the median time to the development of the outcome was shorter in the vitamin-insufficient group.

In a separate analysis of virologic failure, defined as two successive plasma HIV-1 RNA measurements higher than 1,000 copies per milliliter at or after the study’s 16 week visit, those with low vitamin D levels had twice the risk compared to those with sufficient levels. “To our knowledge, this is the first time low 25-hydroxyvitamin D has been associated with HIV virologic failure and represents a novel risk factor for virologic failure,” authors Fiona Havers and colleagues announce.“

We showed prospectively that low 25(OH)D is a predictor of poor clinical outcomes among HIV‐infected adults in diverse geographic, economic and cultural settings,” they conclude. “Our findings support the concept that 25‐hydroxyvitamin D supplementation may be an inexpensive, safe therapeutic addition for HIV‐infected persons, but clearly a well‐designed clinical trial is needed.”

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