Vitamin D supplementation is associated with reduced immune activation levels in HIV-1-infected patients on suppressive antiretroviral therapy

• Published in: AIDS (London) Vol. 28; no. 18; pp. 2677 - 2683
• Main Authors: FABRE-MERSSEMAN, Véronique, TUBIANA, Roland, CABY, Fabienne, SAUCE, Delphine, VIARD, Jean-Paul, APPAY, Victor, PAPAGNO, Laura, BAYARD, Charles, BRICENO, Olivia, FASTENACKELS, Solène, DUDOIT, Yasmine, ROSTANE, Hafeda, SALMON, Dominique, COSTAGLIOLA, Dominique
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 28-11-2014
• Subjects: Adult; AIDS/HIV; Anti-Retroviral Agents - administration & dosage; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiretroviral Therapy, Highly Active - methods; Antiviral agents; B-Lymphocytes - immunology; Biological and medical sciences; CD8-Positive T-Lymphocytes - immunology; Cross-Sectional Studies; Female; HIV Infections - drug therapy; HIV Infections - immunology; HIV Infections - pathology; HIV Infections - virology; HIV-1 - isolation & purification; Human immunodeficiency virus; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Immunophenotyping; Immunosuppressive Agents - administration & dosage; Infectious diseases; Lentivirus; Longitudinal Studies; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Retroviridae; Treatment Outcome; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Vitamin D - administration & dosage; T lymphocytes; Immunopathology; Antiretroviral agent; Immunostimulation; immune activation; AIDS; Immune deficiency; Infection; Chemotherapy; Treatment; Vitamin D; Immunological investigation; Viral disease; T-Lymphocyte; Antiviral; HIV infection
• ISSN: 0269-9370; 1473-5571
• DOI: 10.1097/QAD.0000000000000472

A majority of HIV-1-infected patients present a severe deficit in vitamin D, which predicts short-term mortality. Vitamin D is a naturally synthesized hormone, with important immunomodulatory functions. In the general population, its deficit has been associated with increased markers of inflammation. Vitamin D deficit may therefore play a role in the establishment of elevated systemic immune activation, which persists despite suppressive antiretroviral therapy (ART) in HIV-infected patients, and is predictive of disease progression; and vitamin D supplementation may be beneficial in this context.
We performed both a cross-sectional study (vitamin D deficit versus normal level) and a longitudinal study (upon vitamin D supplementation for 6 to 12 months) of HIV-1-infected patients receiving suppressive ART. The primary outcome measure was the percentage of activated memory CD8(+) T cells in blood, which is a robust marker associated with disease progression. Secondary outcomes included general T-lymphocyte and B-lymphocyte phenotype.
Although vitamin D deficiency had no influence on T-cell and B-cell subset distribution, we found an association between vitamin D and immune activation levels in HIV-1-infected patients. Vitamin D supplementation in vitamin D-deficient patients resulted in reduced immune activation levels.
The present data support the rationale of vitamin D supplementation in the routine clinical management of HIV-1-infected patients, in order to decrease immune activation levels and possibly improve long-term survival.