802. Vitamin D Is Linked to Carotid Intima-Media Thickness (IMT), Inflammation, and Immune Reconstitution in Treated HIV-Infected Individuals
Session: Abstracts: Oral Abstract Session: HIV Complications and Pathogenesis
Friday, October 22, 2010: 2:00 PM
118-120
Background:  Patients with HIV infection (HIV+) are at increased risk of cardiovascular disease (CVD). Vitamin D insufficiency has been associated with increased CVD risk in non-HIV populations. This study sought to determine the relationship between vitamin D status and markers of CVD and HIV-related factors in treated HIV+ subjects. 

Methods:  HIV+ subjects on antiretroviral therapy (ART+) were prospectively enrolled, along with healthy controls (HIV-). Fasting 25-hydroxyvitamin D (25(OH)D), lipids, insulin, inflammation markers (soluble tumor necrosis factor-a receptors I and II (sTNFR-I, -II), interleukin-6 (IL-6), high sensitivity C-reactive protein) and adhesion molecules (soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1) were measured. Internal carotid artery (ICA) and common carotid artery (CCA) IMT was measured in a subset of ART+ subjects, as a surrogate marker for CVD. 

Results:  249 ART+ (56 with carotid IMT), and 34 controls were enrolled.  Controls had higher 25(OH)D levels than ART+ (P=0.01) after accounting for season, race, sex, and age.  In multivariable logistic regression among the ART+ subjects, odds of having CCA IMT above the median was 13 times higher for each standard deviation of 25(OH)D (OR=13.53, 95% CI=2.74, 74.01, P<0.01).  In multivariable linear regression, 25(OH)D was positively associated with CD4 restoration after ART (ΔCD4=current-nadir CD4) and sTNFR-I (P=0.05) in ART+ subjects.

Conclusion:  Vitamin D status in treated HIV+ subjects was positively associated with improved immune restoration after ART and negatively associated with CCA IMT.  These findings suggest that vitamin D may play a role in HIV-related CVD and in immune reconstitution after ART.


Subject Category: H. HIV/AIDS and other retroviruses

Speakers:
Allison C. Ross, MD , Emory University School of Medicine, Atlanta, GA
Suzanne Judd, MPH, PhD , Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL
Vin Tangpricha, MD, PhD , Department of Medicine, Emory University School of Medicine, Atlanta, GA
Meena Kumari, MD , Emory University School of Medicine, Atlanta, GA
Corrilynn O. Hileman, MD , Case Western Reserve University, Cleveland, OH
Norma J. Storer, RN , Case Western Reserve University, Cleveland, OH
Danielle E. Harrill, RN , Case Western Reserve University, Cleveland, OH
Grace A. McComsey, MD , Case Western Reserve University, Cleveland, OH

Disclosures:

A. C. Ross, Yes
GlaxoSmithKline: Grant Investigator, Research grant
Bristol-Myers Squibb: Grant Investigator, Research grant
Cubist Pharmaceuticals: Grant Investigator, Research grant

S. Judd, None

V. Tangpricha, Yes
Genzyme: Grant Investigator, Research grant
NIH K23 AR054334: Grant Investigator, Research grant

M. Kumari, Yes
grant T32 DK007298 : Grant Investigator,

C. O. Hileman, Yes
Bristol-Myers Squibb: Grant Investigator, Research grant and through the Virology Fellow's Research Program

N. J. Storer, None

D. E. Harrill, None

G. A. McComsey, Yes
GlaxoSmithKline: Consultant and Grant Investigator,
Bristol-Myers Squibb: Consultant and Grant Investigator,
Abbott: Consultant and Grant Investigator,
Gilead: Consultant and Grant Investigator,
Merck: Consultant and Grant Investigator,
Pfizer: DSMB chairperson for study ,
NIH grant AI36219: Grant Investigator,

Previous Abstract | Next Abstract >>

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 21 with the exception of research findings presented at IDSA press conferences.

 
 
   
 

Copyright IDSA 2009 Infectious Diseases Society of America 1300 Wilson Boulevard, Suite 300 Arlington, VA 22209 info@idsociety.org