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. 2010 Jan 19;5(1):e8770.
doi: 10.1371/journal.pone.0008770.

Vitamin D status of HIV-infected women and its association with HIV disease progression, anemia, and mortality

Saurabh Mehta  1 , Edward Giovannucci, Ferdinand M Mugusi, Donna Spiegelman, Said Aboud, Ellen Hertzmark, Gernard I Msamanga, David Hunter, Wafaie W Fawzi
Affiliations

Vitamin D status of HIV-infected women and its association with HIV disease progression, anemia, and mortality

Saurabh Mehta et al. PLoS One. .

Abstract

Background: Vitamin D has a potential role in slowing HIV disease progression and preventing mortality based on its extensive involvement in the immune system; however, this relationship has not been examined in large studies or in resource-limited settings.

Methodology/principal findings: Vitamin D levels were assessed in 884 HIV-infected pregnant women at enrollment in a trial of multivitamin supplementation (not including vitamin D) in Tanzania. Women were followed up for a median of 69.5 months, and information on hemoglobin levels, HIV disease progression, and mortality was recorded. Proportional hazard models and generalized estimating equations were used to assess the relationship of these outcomes with vitamin D status.

Conclusions/significance: Low vitamin D status (serum 25-hydroxyvitamin D<32 ng/mL) was significantly associated with progression to WHO HIV disease stage III or greater in multivariate models (incidence rate ratio [RR]: 1.25; 95% confidence intervals [CI]: 1.05, 1.50). No significant relationship was observed between vitamin D status and T-cell counts during follow-up. Women with low vitamin D status had 46% higher risk of developing severe anemia during follow-up, compared to women with adequate vitamin D levels (RR: 1.46; 95% CI: 1.09, 1.96). Women in the highest vitamin D quintile had a 42% lower risk of all-cause mortality, compared to the lowest quintile (RR: 0.58; 95% CI: 0.40, 0.84). Vitamin D status had a protective association with HIV disease progression, all-cause mortality, and development of anemia during follow-up in HIV-infected women. If confirmed in randomized trials, vitamin D supplementation could represent a simple and inexpensive method to prolonging the time to initiation of antiretroviral therapy in HIV-infected patients, particularly in resource-limited settings.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Relationship of Vitamin D status with progression to HIV disease stage III or IV during follow-up.
Figure 2
Figure 2. Relationship of vitamin D status with all-cause mortality among HIV-infected women in Tanzania.
See this image and copyright information in PMC

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