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
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

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


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,

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