Department of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, Warsaw, Poland.
AIDS Res Hum Retroviruses. 2020 Aug;36(8):676-680. doi: 10.1089/AID.2019.0020. Epub 2020 Jun 8.
Low serum vitamin D levels are very common in human immunodeficiency virus (HIV)-infected patients. In our cross-sectional study, we investigated the association between 25-hydroxyvitamin D (25(OH)D) levels and serum inflammation markers [C-reactive protein (CRP), white blood cells (WBC), D-dimers, platelet count (PLT)] in 148 HIV-infected patients on combined antiretroviral therapy [28 on tenofovir alafenamide (TAF)] and 40 healthy controls. The controls were significantly older (56.6 ± 19.1 years for HIV(-) vs. 45.1 ± 11.8 years for HIV(+); = .001) and more females were observed in this group (65% for HIV(-) vs. 16.7% for HIV(+); = .001). The vitamin D serum level was comparable in the two studied groups (74.2 ± 35.9 nmol/L for HIV(+) vs. 78.0 ± 27.6 nnmol/L for HIV(-), = .545). In HIV-infected group, a significant positive correlation between CD4+ cell percentage and vitamin D level was observed ( = 0.17; = .036). Furthermore, the significant negative correlation between vitamin D level and CD8+ cell percentage, PLT, CRP, and D-dimers was seen. In univariate analysis, only TAF use and AIDS status was associated with vitamin D level deficiency. No other antiretroviral (ARV) drug nor gender or smoking had influence on vitamin D serum level. In multivariate analysis, only AIDS status and CRP level were correlated with vitamin D level (slope estimate = 11.6 and = .032 and slope estimate = -0.83 and = .002; respectively). In summary, we report that low vitamin D level may be associated with high CRP level in HIV-infected patients on suppressive antiretroviral therapy, especially in AIDS phase. More larger studies are required to assess our observation concerning TAF use and vitamin D level in HIV-positive patients.
血清维生素 D 水平低下在人类免疫缺陷病毒(HIV)感染者中非常常见。在我们的横断面研究中,我们调查了 148 名接受联合抗逆转录病毒治疗(28 名接受替诺福韦艾拉酚胺(TAF))的 HIV 感染者和 40 名健康对照者的 25-羟维生素 D(25(OH)D)水平与血清炎症标志物[C 反应蛋白(CRP)、白细胞(WBC)、D-二聚体、血小板计数(PLT)]之间的关系。对照组年龄明显较大(HIV(-)为 56.6±19.1 岁,HIV(+)为 45.1±11.8 岁;=0.001),且该组中女性比例较高(HIV(-)为 65%,HIV(+)为 16.7%;=0.001)。两组的维生素 D 血清水平相当(HIV(+)为 74.2±35.9 nmol/L,HIV(-)为 78.0±27.6 nmol/L,=0.545)。在 HIV 感染者组中,观察到 CD4+细胞百分比与维生素 D 水平之间存在显著正相关(=0.17;=0.036)。此外,还观察到维生素 D 水平与 CD8+细胞百分比、PLT、CRP 和 D-二聚体之间存在显著负相关。在单变量分析中,只有 TAF 使用和 AIDS 状态与维生素 D 水平缺乏有关。其他抗逆转录病毒(ARV)药物、性别或吸烟均未影响血清维生素 D 水平。在多变量分析中,只有 AIDS 状态和 CRP 水平与维生素 D 水平相关(斜率估计值分别为 11.6 和=0.032,斜率估计值为-0.83 和=0.002)。总之,我们报告在接受抑制性抗逆转录病毒治疗的 HIV 感染者中,低维生素 D 水平可能与高 CRP 水平相关,尤其是在 AIDS 阶段。需要进行更多的大型研究来评估我们关于 TAF 使用和 HIV 阳性患者维生素 D 水平的观察结果。