Change in serum 25-hydroxyvitamin D with antiretroviral treatment initiation and nutritional intervention in HIV-positive adults. Issue 10 (8th November 2016)

• Record Type: Journal Article
• Authors: Yilma, Daniel; Kæstel, Pernille; Olsen, Mette F.; Abdissa, Alemseged; Tesfaye, Markos; Girma, Tsinuel; Krarup, Henrik; Mølgaard, Christian; Michaelsen, Kim F.; Ritz, Christian; Kirk, Ole; Andersen, Åse B.; Friis, Henrik
• Is Part Of: British journal of nutrition. Volume 116:Issue 10(2016)
• Page Start: 1720
• Page End: 1727
• Publication Date: 2016-11-08
• Subjects: HIV, -- Vitamin D, -- Nutritional intervention, -- Antiretroviral treatment; Nutrition -- Periodicals; 572.4
• DOI: 10.1017/S0007114516003743
• Languages: English
• ISSNs: 0007-1145

Abstract

Abstract: Low vitamin D level in HIV-positive persons has been associated with disease progression. We compared the levels of serum 25-hydroxyvitamin D (25(OH)D) in HIV-positive and HIV-negative persons, and investigated the role of nutritional supplementation and antiretroviral treatment (ART) on serum 25(OH)D levels. A randomised nutritional supplementation trial was conducted at Jimma University Specialized Hospital, Ethiopia. The trial compared 200 g/d of lipid-based nutrient supplement (LNS) with no supplementation during the first 3 months of ART. The supplement provided twice the recommended daily allowance of vitamin D (10 μg/200 g). The level of serum 25(OH)D before nutritional intervention and ART initiation was compared with serum 25(OH)D of HIV-negative individuals. A total of 348 HIV-positive and 100 HIV-negative persons were recruited. The median baseline serum 25(OH)D level was higher in HIV-positive than in HIV-negative persons (42·5 v . 35·3 nmol/l, P <0·001). In all, 282 HIV-positive persons with BMI>17 kg/m 2 were randomised to either LNS supplementation ( n 189) or no supplementation ( n 93) during the first 3 months of ART. The supplemented group had a 4·1 (95 % CI 1·7, 6·4) nmol/l increase in serum 25(OH)D, whereas the non-supplemented group had a 10·8 (95 % CI 7·8, 13·9) nmol/l decrease in serum 25(OH)D level after 3 months of ART. Nutritional supplementation that contained vitamin D prevented a reduction in serum 25(OH)D levels in HIV-positive persons initiating ART. Vitamin D replenishment may be needed to prevent reduction in serum 25(OH)D levels during ART.