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Vitamin D supplementation decreases immune activation and exhaustion in HIV-1-infected youth.
Eckard, Allison Ross; O'Riordan, Mary Ann; Rosebush, Julia C; Lee, Seungeun Thera; Habib, Jakob G; Ruff, Joshua H; Labbato, Danielle; Daniels, Julie E; Uribe-Leitz, Monika; Tangpricha, Vin; Chahroudi, Ann; McComsey, Grace A.
Afiliação
  • Eckard AR; Medical University of South Carolina, Charleston, SC, USA.
  • O'Riordan MA; Emory University School of Medicine, Atlanta, GA, USA.
  • Rosebush JC; Rainbow Babies & Children's Hospital and Case Western Reserve University School of Medicine, Cleveland, OH, USA.
  • Lee ST; Emory University School of Medicine, Atlanta, GA, USA.
  • Habib JG; Emory University School of Medicine, Atlanta, GA, USA.
  • Ruff JH; Emory University School of Medicine, Atlanta, GA, USA.
  • Labbato D; Emory University School of Medicine, Atlanta, GA, USA.
  • Daniels JE; Rainbow Babies & Children's Hospital and Case Western Reserve University School of Medicine, Cleveland, OH, USA.
  • Uribe-Leitz M; Emory University School of Medicine, Atlanta, GA, USA.
  • Tangpricha V; Emory University School of Medicine, Atlanta, GA, USA.
  • Chahroudi A; Emory University School of Medicine, Atlanta, GA, USA.
  • McComsey GA; Emory University School of Medicine, Atlanta, GA, USA.
Antivir Ther ; 23(4): 315-324, 2018.
Article em En | MEDLINE | ID: mdl-28994661
ABSTRACT

BACKGROUND:

Heightened immune activation and exhaustion drive HIV disease progression and comorbidities. Vitamin D has pleiotropic immunomodulatory effects, but little is known about the effects of supplementation in HIV. Our study investigates changes in immune activation and exhaustion markers after 12 months of supplementation in virologically suppressed HIV-infected youth with vitamin D insufficiency.

METHODS:

This is a randomized, active-control, double-blind trial investigating with three different vitamin D3 doses (18,000 [standard/active-control dose], 60,000 [moderate dose] and 120,000 IU/month [high dose]) in 8-25-year-old HIV-infected youth on combination antiretroviral therapy with baseline serum 25-hydroxyvitamin D (25(OH)D) concentrations ≤30 ng/ml. Only subjects (n=51) who maintained an undetectable HIV-1 RNA over the 12-month study period were included in this analysis.

RESULTS:

Baseline serum 25(OH)D concentrations and immune activation/exhaustion markers were not different between groups. By 12 months, 25(OH)D increased significantly within each dosing group with the greatest increase and most sustained concentrations ≥30 ng/ml in the high-dose group. Overall, all measured markers decreased with CD4 activation (CD4+CD38+HLA-DR+), CD8 activation (CD8+CD38+HLA-DR+), CD4 exhaustion (CD4+CD38+HLA-DR+PD1+) and inflammatory monocytes (CD14+CD16+) reaching statistical significance. When analysed separately, there were no significant decreases in the moderate- or standard-dose groups, but CD4 and CD8 activation and inflammatory monocytes decreased significantly in the high-dose group.

CONCLUSIONS:

Vitamin D supplementation decreased markers of T-cell activation/exhaustion and monocyte activation in HIV-infected youth, with subjects given the highest dose (120,000 IU/month) showing the greatest decreases. These data suggest that high-dose vitamin D supplementation may attenuate immune activation and exhaustion, and serve as adjuvant therapy to antiretroviral therapy in HIV. ClinicalTrials.gov identifier NCT01523496.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Vitamina D / Infecções por HIV / HIV-1 / Suplementos Nutricionais / Interações Hospedeiro-Patógeno / Imunomodulação Tipo de estudo: Clinical_trials / Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Child / Female / Humans / Male Idioma: En Revista: Antivir Ther Assunto da revista: TERAPIA POR MEDICAMENTOS / VIROLOGIA Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Vitamina D / Infecções por HIV / HIV-1 / Suplementos Nutricionais / Interações Hospedeiro-Patógeno / Imunomodulação Tipo de estudo: Clinical_trials / Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Child / Female / Humans / Male Idioma: En Revista: Antivir Ther Assunto da revista: TERAPIA POR MEDICAMENTOS / VIROLOGIA Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Estados Unidos