Title: Prevalence of Vitamin-D Deficiency in HIV Positive Patients and its Correlation with Occurrence of Opportunistic Infections and CD4 Counts
Authors: Dr Sivaprakash Varadan, Dr Sudagarsingh. RB, Chandu P, Dr Vasanthan, Dr Damodharan J
DOI: https://dx.doi.org/10.18535/jmscr/v5i12.86
Abstract
The vitamin D endocrine system plays an essential role in calcium homeostasis and bone metabolism required for optimal absorption of dietary calcium and phosphate. Apart from role in calcium homeostasis other biological actions include induction of cell differentiation, inhibition of cell growth, immunomodulation and control of other hormonal systems. Several studies have demonstrated low serum vitamin 25(OH)D levels in populations across India. Very high percentage of HIV -infected people live in areas of the world where nutritional deficiencies are also highly prevalent, and the interactions between HIV and nutritional status have been documented. In last few years there have been reports suggesting an increased prevalence of osteopenia and osteoporosis in HIV positive patients 7,8,9. Middle-aged persons with human immunodeficiency virus (HIV) infection are at risk for numerous co-morbidities typically seen including metabolic syndrome, osteoporosis and fractures, insulin resistance, diabetes, cardiovascular disease, cognitive impairment and opportunistic infection .Many of which have also been associated with vitamin D deficiency.
HIV infection and exposure to certain antiretroviral might contribute to altered levels of 25(OH) vitamin D.Vitamin D insufficiency or deficiency may increase the incidence of opportunistic infection in HIV patients. Vitamin D level in HIV patients and its co- relation with opportunistic infection and immunological status are not yet well defined. Therefore present study is designed to find the correlation between HIV status and vitamin D levels.
References
- Arya V,Bhambri R, Godbole MM, Mithal A. Vitamin D status and its relationship with bone mineral density in healthy Asian Indians. Osteoporos Int.2004; 15 :56-61.
- Sachan A, Gupta R, Das V. High prevalence of vitamin D deficiency among pregnant women and their newborns in northern In dia. Am J Clin Nutr.2005; 81: 1 060-1 064.
- Puri S, Marwaha RK, Agarwal N. Vitamin D status of apparently healthy school iris from two different socioeconomic strata in Delhi: relation to nutrition and lifestyle. BrJ Nutr.2008; 99:876-882.
- Sahu M, Bhatia V, Aggarwal A, Rawat V, Saxena P. Vitamin D deficiency in rural girls and pregnant women despite abundant sunshine in northern India. Clin Endocrinol (Oxf).2009 May;70(5):680-4.
- Tang AM, Graham NM, Kirby AJ, McCall LD, Willett WC, Saah AJ. Dietary micronutrient intake and risk of progression to acquired immunodeficiency syndrome (AIDS) in human immunodeficiency virus type I (HIV -1 )-infected homosexual men. AmJ Epidemiol. 1993;138:937-951.
- Fawzi WW, Msamanga GI, Spiegelman D.A randomized trial of multivitamin supplements and randomized trial of multivitamin supplements and J Med. 2004;351 :23-32
- Tebas P, Powderly WG, Claxton S. Accelerated bone mineral loss in HIV-infectedpatients receiving potent antiretroviral therapy. AIDS 2000;14:F63-F67.
- Moore AL, Vashisht A, Sabin CA. Reduced bone mineral density in HIV positive individuals. AIDS 2001; 15: 1731-1733.
- Garcia Aparicio AM, Mun - oz Fernandez S, Gonzalez J. Abnormalities in the bonemineral metabolism in HIV- infected patients. Clin Rheumato12006;25:537-539.
- Tangpricha V, Pearce EN, Holick MF. Vitamin D insufficiency among free-living healthy young adults. Am J Med. 2002;112:659-662.
- Bhalla AK, Amento EP, Clemens TL, Holick MF, KraneSM..Specific high-affinity receptors for 1,25 dihydroxyvitamin D3 in human peripheral blood mononuclear cells: presence in monocytes and in-duct ion in T lymphocytes following activation. J Clin Endocrinol Metab. 1983;57: 1308-1310.
- Paul TV, Asha HS, Thomas N, Seshadri MS, Rupali P. Hypovitaminosis D and bone mineral density in human immunodeficiency virus-infected men from India, with or without antiretroviral therapy. Endocr Pract. 2010 Jul-Aug;16(4):547-53.
- Dao CN, Patel P, Overton ET, Rhame F, Pals SL, Johnson C. Low vitamin D among HIV -infected adults: prevalence of and risk factors for low vitamin D Levels in a cohort of HIV-infected adults and comparison to prevalence among adults in the US general population. Clin Infect Dis. 2011 Feb;52(3):396-405.