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Vitamin D status in Well-Controlled Caucasian HIV Patients in Relation to Inflammatory and Metabolic Markers--A
C Missailidis1,2, J Höijer3, M Johansson4
1Department of Laboratory Medicine (LABMED), Division of Clinical Microbiology, Karolinska Institute, Stockholm, Sweden.
Insights
Vitamin D levels were low and similar in well-controlled HIV patients and healthy controls. Low vitamin D was not linked to microbial translocation, inflammation, or lipid issues in HIV patients, questioning supplementation benefits.
Area of Science:
- Immunology
- Endocrinology
- Infectious Diseases
Background:
- HIV infection is associated with chronic inflammation and metabolic disturbances.
- Vitamin D deficiency is common in HIV patients, but its role in disease progression and complications is unclear.
- Understanding vitamin D's relationship with microbial translocation, inflammation, and dyslipidemia is crucial for managing HIV.
Purpose of the Study:
- To investigate the association between vitamin D (25OH D3) levels and markers of microbial translocation, systemic inflammation, and blood lipids.
- To compare these parameters between well-controlled HIV patients on HAART and healthy controls.
Main Methods:
- Plasma and serum samples from 97 HIV patients (immeasurable viral load) and 30 healthy controls were analyzed.
- Measurements included vitamin D, LPS (microbial translocation), sCD14, hsCRP, IL-4, IL-6, IL-10, IL-17, MCP-1, IFN-γ (inflammation), and blood lipids.
- Statistical analysis was performed to determine associations.
Main Results:
- Vitamin D levels were similarly low in both HIV patients and controls.
- No association was found between vitamin D levels and microbial translocation, inflammation, or dyslipidemia.
- HIV patients showed higher sCD14 and hsCRP levels, and elevated cholesterol and Apo B, independent of vitamin D.
- Smoking was more prevalent in HIV patients and associated with lower vitamin D.
Conclusions:
- Well-treated HIV patients have similar vitamin D levels to controls, which are often low.
- Increased inflammation and dyslipidemia in HIV patients are linked to the disease itself, not low vitamin D.
- Vitamin D supplementation may not be effective for improving microbial translocation or systemic inflammation in this population.
Abstract:
To study vitamin D (25OH D3 ) in relation to (i) microbial translocation (ii) systemic inflammation and (iii) blood lipid markers, in Caucasian, well-controlled HIV patients and healthy controls, plasma and serum samples from n = 97 male, HIV patients on HAART with immeasurable viral load (<20 copies/ml) since median 6.5 years and no concurrent inflammatory or infectious disease and n = 30 healthy controls were analysed for (i) LPS; (ii) sCD14, hsCRP, IL-4, IL-6, IL-10, IL-17, MCP-1 and IFN-γ; as well as (iii) blood lipids. Vitamin D levels were similarly distributed and equally low in both HIV patients and controls. There was no association between vitamin D levels and markers of microbial translocation, systemic inflammation or dyslipidemia. LPS levels were similar in both groups but HIV patients expressed higher levels of sCD14 and hsCRP, with HIV as an independent risk factor. HIV patients had higher cholesterol and Apo B levels. Notably, more HIV patients smoked and smoking was associated with lower vitamin D levels. In conclusion; these well-treated Caucasian HIV patients had similar vitamin D levels as healthy controls. However, despite perfect virological control, they exhibited slightly increased inflammatory markers and disturbed blood lipids. However, neither of these parameters were associated with low vitamin D levels but appeared to be linked to the HIV-disease per se. Thus, the rationale for vitamin D substitution as a way to improve microbial translocation and systemic inflammation is not fully supported in this HIV population.
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