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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Vitamin D Status and Incidence of Pulmonary Tuberculosis, Opportunistic Infections, and Wasting Among HIV-Infected Tanzanian Adults Initiating Antiretroviral Therapy</title><author><name sortKey="Sudfeld, Christopher R" sort="Sudfeld, Christopher R" uniqKey="Sudfeld C" first="Christopher R." last="Sudfeld">Christopher R. Sudfeld</name><affiliation><nlm:aff id="af1"><addr-line>Department of Epidemiology</addr-line></nlm:aff></affiliation></author><author><name sortKey="Giovannucci, Edward L" sort="Giovannucci, Edward L" uniqKey="Giovannucci E" first="Edward L." last="Giovannucci">Edward L. Giovannucci</name><affiliation><nlm:aff id="af1"><addr-line>Department of Epidemiology</addr-line></nlm:aff></affiliation><affiliation><nlm:aff id="af3"><addr-line>Department of Nutrition</addr-line></nlm:aff></affiliation><affiliation><nlm:aff id="af5"><addr-line>Channing Laboratory, Department of Medicine</addr-line>,<institution>Brigham and Women's Hospital</institution>,<addr-line>Boston, Massachusetts</addr-line></nlm:aff></affiliation></author><author><name sortKey="Isanaka, Sheila" sort="Isanaka, Sheila" uniqKey="Isanaka S" first="Sheila" last="Isanaka">Sheila Isanaka</name><affiliation><nlm:aff id="af3"><addr-line>Department of Nutrition</addr-line></nlm:aff></affiliation></author><author><name sortKey="Aboud, Said" sort="Aboud, Said" uniqKey="Aboud S" first="Said" last="Aboud">Said Aboud</name><affiliation><nlm:aff id="af6"><addr-line>Department of Microbiology and Immunology</addr-line></nlm:aff></affiliation></author><author><name sortKey="Mugusi, Ferdinand M" sort="Mugusi, Ferdinand M" uniqKey="Mugusi F" first="Ferdinand M." last="Mugusi">Ferdinand M. Mugusi</name><affiliation><nlm:aff id="af7"><addr-line>Department of Internal Medicine</addr-line>,<institution>Muhimbili University of Health and Allied Sciences</institution></nlm:aff></affiliation></author><author><name sortKey="Wang, Molin" sort="Wang, Molin" uniqKey="Wang M" first="Molin" last="Wang">Molin Wang</name><affiliation><nlm:aff id="af2"><addr-line>Department of Biostatistics</addr-line></nlm:aff></affiliation></author><author><name sortKey="Chalamilla, Guerino" sort="Chalamilla, Guerino" uniqKey="Chalamilla G" first="Guerino" last="Chalamilla">Guerino Chalamilla</name><affiliation><nlm:aff id="af8"><addr-line>Management and Development for Health, Dar es Salaam</addr-line>,<country>Tanzania</country></nlm:aff></affiliation></author><author><name sortKey="Fawzi, Wafaie W" sort="Fawzi, Wafaie W" uniqKey="Fawzi W" first="Wafaie W." last="Fawzi">Wafaie W. Fawzi</name><affiliation><nlm:aff id="af1"><addr-line>Department of Epidemiology</addr-line></nlm:aff></affiliation><affiliation><nlm:aff id="af3"><addr-line>Department of Nutrition</addr-line></nlm:aff></affiliation><affiliation><nlm:aff id="af4"><addr-line>Department of Global Health and Population</addr-line>,<institution>Harvard School of Public Health</institution></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23162137</idno><idno type="pmc">3537448</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3537448</idno><idno type="RBID">PMC:3537448</idno><idno type="doi">10.1093/infdis/jis693</idno><date when="2012">2012</date><idno type="wicri:Area/Pmc/Corpus">001696</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001696</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Vitamin D Status and Incidence of Pulmonary Tuberculosis, Opportunistic Infections, and Wasting Among HIV-Infected Tanzanian Adults Initiating Antiretroviral Therapy</title><author><name sortKey="Sudfeld, Christopher R" sort="Sudfeld, Christopher R" uniqKey="Sudfeld C" first="Christopher R." last="Sudfeld">Christopher R. Sudfeld</name><affiliation><nlm:aff id="af1"><addr-line>Department of Epidemiology</addr-line></nlm:aff></affiliation></author><author><name sortKey="Giovannucci, Edward L" sort="Giovannucci, Edward L" uniqKey="Giovannucci E" first="Edward L." last="Giovannucci">Edward L. Giovannucci</name><affiliation><nlm:aff id="af1"><addr-line>Department of Epidemiology</addr-line></nlm:aff></affiliation><affiliation><nlm:aff id="af3"><addr-line>Department of Nutrition</addr-line></nlm:aff></affiliation><affiliation><nlm:aff id="af5"><addr-line>Channing Laboratory, Department of Medicine</addr-line>,<institution>Brigham and Women's Hospital</institution>,<addr-line>Boston, Massachusetts</addr-line></nlm:aff></affiliation></author><author><name sortKey="Isanaka, Sheila" sort="Isanaka, Sheila" uniqKey="Isanaka S" first="Sheila" last="Isanaka">Sheila Isanaka</name><affiliation><nlm:aff id="af3"><addr-line>Department of Nutrition</addr-line></nlm:aff></affiliation></author><author><name sortKey="Aboud, Said" sort="Aboud, Said" uniqKey="Aboud S" first="Said" last="Aboud">Said Aboud</name><affiliation><nlm:aff id="af6"><addr-line>Department of Microbiology and Immunology</addr-line></nlm:aff></affiliation></author><author><name sortKey="Mugusi, Ferdinand M" sort="Mugusi, Ferdinand M" uniqKey="Mugusi F" first="Ferdinand M." last="Mugusi">Ferdinand M. Mugusi</name><affiliation><nlm:aff id="af7"><addr-line>Department of Internal Medicine</addr-line>,<institution>Muhimbili University of Health and Allied Sciences</institution></nlm:aff></affiliation></author><author><name sortKey="Wang, Molin" sort="Wang, Molin" uniqKey="Wang M" first="Molin" last="Wang">Molin Wang</name><affiliation><nlm:aff id="af2"><addr-line>Department of Biostatistics</addr-line></nlm:aff></affiliation></author><author><name sortKey="Chalamilla, Guerino" sort="Chalamilla, Guerino" uniqKey="Chalamilla G" first="Guerino" last="Chalamilla">Guerino Chalamilla</name><affiliation><nlm:aff id="af8"><addr-line>Management and Development for Health, Dar es Salaam</addr-line>,<country>Tanzania</country></nlm:aff></affiliation></author><author><name sortKey="Fawzi, Wafaie W" sort="Fawzi, Wafaie W" uniqKey="Fawzi W" first="Wafaie W." last="Fawzi">Wafaie W. Fawzi</name><affiliation><nlm:aff id="af1"><addr-line>Department of Epidemiology</addr-line></nlm:aff></affiliation><affiliation><nlm:aff id="af3"><addr-line>Department of Nutrition</addr-line></nlm:aff></affiliation><affiliation><nlm:aff id="af4"><addr-line>Department of Global Health and Population</addr-line>,<institution>Harvard School of Public Health</institution></nlm:aff></affiliation></author></analytic><series><title level="j">The Journal of Infectious Diseases</title><idno type="ISSN">0022-1899</idno><idno type="eISSN">1537-6613</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><bold><italic>Background.</italic></bold> Maintaining vitamin D sufficiency may decrease the incidence of pulmonary tuberculosis and other infectious diseases. We present the first prospective study of vitamin D among human immunodeficiency virus (HIV)–infected adults receiving antiretrovirals in sub-Saharan Africa.</p><p><bold><italic>Methods.</italic></bold> Serum 25-hydroxyvitamin D (25(OH)D) level was assessed at antiretroviral therapy (ART) initiation for 1103 HIV-infected adults enrolled in a trial of multivitamins (not including vitamin D) in Tanzania. Participants were prospectively followed at monthly visits at which trained physicians performed a clinical examination and nurses took anthropometric measurements and assessed self-reported symptoms. Cox proportional hazards models estimated hazard ratios (HRs) of morbidity outcomes.</p><p><bold><italic>Results.</italic></bold> After multivariate adjustment, vitamin D deficiency (defined as a concentration of <20 ng/mL) had a significantly greater association with incident pulmonary tuberculosis, compared with vitamin D sufficiency (HR, 2.89; 95% confidence interval [CI], 1.31–7.41; <italic>P</italic> = .027), but no association was found for vitamin D insufficiency (defined as a concentration of 20–30 ng/mL; <italic>P</italic> = .687). Deficiency was also significantly associated with incident oral thrush (HR, 1.96; 95% CI, 1.01–3.81; <italic>P</italic> = .046), wasting (HR, 3.10; 95% CI, 1.33–7.24; <italic>P</italic> = .009), and >10% weight loss (HR, 2.10; 95% CI, 1.13–3.91; <italic>P</italic> = .019). Wasting results were robust to exclusion of individuals experiencing pulmonary tuberculosis. Vitamin D status was not associated with incident malaria, pneumonia, or anemia.</p><p><bold><italic>Conclusions.</italic></bold> Vitamin D supplementation trials for adults receiving ART appear to be warranted.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Infect Dis</journal-id><journal-id journal-id-type="iso-abbrev">J. Infect. Dis</journal-id><journal-id journal-id-type="publisher-id">jid</journal-id><journal-id journal-id-type="hwp">jinfdis</journal-id><journal-title-group><journal-title>The Journal of Infectious Diseases</journal-title></journal-title-group><issn pub-type="ppub">0022-1899</issn><issn pub-type="epub">1537-6613</issn><publisher><publisher-name>Oxford University Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23162137</article-id><article-id pub-id-type="pmc">3537448</article-id><article-id pub-id-type="doi">10.1093/infdis/jis693</article-id><article-id pub-id-type="publisher-id">jis693</article-id><article-categories><subj-group subj-group-type="heading"><subject>Major Articles and Brief Reports</subject><subj-group subj-group-type="heading"><subject>HIV/AIDS</subject></subj-group></subj-group></article-categories><title-group><article-title>Vitamin D Status and Incidence of Pulmonary Tuberculosis, Opportunistic Infections, and Wasting Among HIV-Infected Tanzanian Adults Initiating Antiretroviral Therapy</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Sudfeld</surname><given-names>Christopher R.</given-names></name><xref ref-type="aff" rid="af1">1</xref></contrib><contrib contrib-type="author"><name><surname>Giovannucci</surname><given-names>Edward L.</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="aff" rid="af3">3</xref><xref ref-type="aff" rid="af5">5</xref></contrib><contrib contrib-type="author"><name><surname>Isanaka</surname><given-names>Sheila</given-names></name><xref ref-type="aff" rid="af3">3</xref></contrib><contrib contrib-type="author"><name><surname>Aboud</surname><given-names>Said</given-names></name><xref ref-type="aff" rid="af6">6</xref></contrib><contrib contrib-type="author"><name><surname>Mugusi</surname><given-names>Ferdinand M.</given-names></name><xref ref-type="aff" rid="af7">7</xref></contrib><contrib contrib-type="author"><name><surname>Wang</surname><given-names>Molin</given-names></name><xref ref-type="aff" rid="af2">2</xref></contrib><contrib contrib-type="author"><name><surname>Chalamilla</surname><given-names>Guerino</given-names></name><xref ref-type="aff" rid="af8">8</xref></contrib><contrib contrib-type="author"><name><surname>Fawzi</surname><given-names>Wafaie W.</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="aff" rid="af3">3</xref><xref ref-type="aff" rid="af4">4</xref></contrib></contrib-group><aff id="af1"><label>1</label><addr-line>Department of Epidemiology</addr-line></aff><aff id="af2"><label>2</label><addr-line>Department of Biostatistics</addr-line></aff><aff id="af3"><label>3</label><addr-line>Department of Nutrition</addr-line></aff><aff id="af4"><label>4</label><addr-line>Department of Global Health and Population</addr-line>,<institution>Harvard School of Public Health</institution></aff><aff id="af5"><label>5</label><addr-line>Channing Laboratory, Department of Medicine</addr-line>,<institution>Brigham and Women's Hospital</institution>,<addr-line>Boston, Massachusetts</addr-line></aff><aff id="af6"><label>6</label><addr-line>Department of Microbiology and Immunology</addr-line></aff><aff id="af7"><label>7</label><addr-line>Department of Internal Medicine</addr-line>,<institution>Muhimbili University of Health and Allied Sciences</institution></aff><aff id="af8"><label>8</label><addr-line>Management and Development for Health, Dar es Salaam</addr-line>,<country>Tanzania</country></aff><author-notes><corresp>Correspondence: Christopher R. Sudfeld, ScM, Department of Epidemiology, Harvard School of Public Health, 667 Huntington Ave, Bldg 1, Rm 1102, Boston, MA 02115 (<email>csudfeld@hsph.harvard.edu</email>).</corresp></author-notes><pub-date pub-type="ppub"><day>1</day><month>2</month><year>2013</year></pub-date><pub-date pub-type="epub"><day>16</day><month>11</month><year>2012</year></pub-date><volume>207</volume><issue>3</issue><fpage>378</fpage><lpage>385</lpage><history><date date-type="received"><day>13</day><month>6</month><year>2012</year></date><date date-type="accepted"><day>4</day><month>9</month><year>2012</year></date></history><permissions><copyright-statement>© The Author 2012. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: <email>journals.permissions@oup.com</email>.</copyright-statement><copyright-year>2012</copyright-year></permissions><self-uri content-type="pdf" xlink:type="simple" xlink:href="jis693.pdf"></self-uri><abstract><p><bold><italic>Background.</italic></bold> Maintaining vitamin D sufficiency may decrease the incidence of pulmonary tuberculosis and other infectious diseases. We present the first prospective study of vitamin D among human immunodeficiency virus (HIV)–infected adults receiving antiretrovirals in sub-Saharan Africa.</p><p><bold><italic>Methods.</italic></bold> Serum 25-hydroxyvitamin D (25(OH)D) level was assessed at antiretroviral therapy (ART) initiation for 1103 HIV-infected adults enrolled in a trial of multivitamins (not including vitamin D) in Tanzania. Participants were prospectively followed at monthly visits at which trained physicians performed a clinical examination and nurses took anthropometric measurements and assessed self-reported symptoms. Cox proportional hazards models estimated hazard ratios (HRs) of morbidity outcomes.</p><p><bold><italic>Results.</italic></bold> After multivariate adjustment, vitamin D deficiency (defined as a concentration of <20 ng/mL) had a significantly greater association with incident pulmonary tuberculosis, compared with vitamin D sufficiency (HR, 2.89; 95% confidence interval [CI], 1.31–7.41; <italic>P</italic> = .027), but no association was found for vitamin D insufficiency (defined as a concentration of 20–30 ng/mL; <italic>P</italic> = .687). Deficiency was also significantly associated with incident oral thrush (HR, 1.96; 95% CI, 1.01–3.81; <italic>P</italic> = .046), wasting (HR, 3.10; 95% CI, 1.33–7.24; <italic>P</italic> = .009), and >10% weight loss (HR, 2.10; 95% CI, 1.13–3.91; <italic>P</italic> = .019). Wasting results were robust to exclusion of individuals experiencing pulmonary tuberculosis. Vitamin D status was not associated with incident malaria, pneumonia, or anemia.</p><p><bold><italic>Conclusions.</italic></bold> Vitamin D supplementation trials for adults receiving ART appear to be warranted.</p></abstract><kwd-group><kwd>Vitamin D</kwd><kwd>micronutrient</kwd><kwd>HIV</kwd><kwd>tuberculosis</kwd><kwd>wasting</kwd><kwd>malaria</kwd><kwd>pneumonia</kwd><kwd>morbidity</kwd><kwd>ART</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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