438. Cross Sectional Study of Vitamin D Levels and Immunologic Outcomes in HIV Infected Adults
Session: Poster Abstract Session: HIV Challenges and Complications
Friday, October 21, 2011
Room: Poster Hall B1
Background: Vitamin D may be an important immunomodulator.  Studies have shown lower levels of vitamin D (25-hydroxyvitamin D) and its active form, (1,25-dihydroxyvitamin D) in persons with HIV. We evaluated the relationship between vitamin D levels (1,25-dihydroxyvitamin D, and 25-hydroxyvitaminD) and viral load, as well as to CD4. 

Methods: A cross-sectional study, involving a one-time blood-draw, was completed with 112 HIV positive adult subjects who receive care either at a large university-based HIV clinic, or an urban community HIV clinic. Correlation coefficients and linear regression were done.

Results: The 112 subjects included 26 women and 86 men. 76 (68%) were from the University clinic, while 36 (32%) were from the urban clinic.  The mean 25, hydroxyvitamin D level among the 112 subjects was 22.5 ng/mL (range 5-58, normal 30-80 ng/mL).  The mean 1,25 hydroxyvitamin D level was 23.5 pg/mL (range 1-51, normal 5-75 pg/mL).  22% of subjects had 25,hydroxyvitamin D levels ≤10 ng/mL, representing severe deficiency, 75% had values between 11 and 30 ng/mL, and values of ≥31 ng/mL were found in 39%. 58% of subjects from the urban clinic were severely deficient, while only 5.3% of subjects from the University clinic had values ≤10 ng/mL. Subjects from the urban clinic had 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels 17 ng/mL and 13 pg/mL less compared to subjects from the University clinic (P <0.0001 and <0.0034 respectively).  No statistically significant correlations between 25-hydroxyvitamin D levels and viral loads, or CD4 counts were found among the 112 subjects. Viral load and 1,25-dihydroxyvitamin D levels had a trend toward correlation (CORR 0.13, P=0.17). Subset analysis of subjects with unsuppressed viral loads (>1000 copies) revealed a correlation between 25-hydroxyvitamin D and viral load (CORR 0.36, P=0.019) and trend between 1,25-dihydroxyvitamin D and viral load (CORR 0.24, P=0.138). 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels were highly correlated (CORR 0.49, P<0.0001).

Conclusion: We found low levels of vitamin D in an HIV population and an inverse relationship between 25-hydroxyvitamin D and viral load. Future studies should examine the effect of vitamin D supplementation on HIV viral load.   


Subject Category: H. HIV/AIDS and other retroviruses

Allison Bearden, MD, MPH, Division of Infectious Disease, University of Wisconsin School of Medicine and Public Health, Madison, Madison, WI, Cybele Lara Abad, MD, Milwaukee Health Services, Milwaukee, WI, James Sosman, MD, Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, Neil Binkley, MD, Medicine, Division of Geriatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI and Nasia Safdar, MD, PhD, Section of Infectious Diseases, University of Wisconsin School of Medicine and Public Health, Madison, WI

Disclosures:

A. Bearden, None

C. L. Abad, None

J. Sosman, None

N. Binkley, None

N. Safdar, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.