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Prognostic Value of Vitamin D Level for All-cause Mortality, and Association With Inflammatory Markers, in HIV-infected Persons

Identifieur interne : 004001 ( Main/Exploration ); précédent : 004000; suivant : 004002

Prognostic Value of Vitamin D Level for All-cause Mortality, and Association With Inflammatory Markers, in HIV-infected Persons

Auteurs : Leah Shepherd [Royaume-Uni] ; Jean-Claude Souberbielle [France] ; Jean-Philippe Bastard [France] ; Soraya Fellahi [France] ; Jaqueline Capeau [France] ; Joanne Reekie [Royaume-Uni, Australie] ; Peter Reiss [Pays-Bas] ; Anders Blaxhult [Suède] ; Markus Bickel [Allemagne] ; Clifford Leen [Royaume-Uni] ; Ole Kirk [Danemark] ; Jens D. Lundgren [Danemark] ; Amanda Mocroft [Royaume-Uni] ; Jean-Paul Viard [France]

Source :

RBID : Pascal:14-0211985

Descripteurs français

English descriptors

Abstract

Background. Low 25-hydroxyvitamin D (25(OH)D) has been associated with inflammation, human immunodeficiency virus (HIV) disease progression, and death. We aimed to identify the prognostic value of 25(OH)D for AIDS, non-AIDS-defining events and death, and its association with immunological/inflammatory markers. Methods. Prospective 1-1 case-control study nested within the EuroSIDA cohort. Matched cases and controls for AIDS (n = 50 matched pairs), non-AIDS-defining (n = 63) events and death (n = 41), with plasma samples during follow-up were selected. Conditional logistic regression models investigated associations between 25(OH)D levels and annual 25(OH)D change and the probability of events. Mixed models investigated relationships between 25(OH)D levels and immunological/inflammatory markers. Results. In sum, 250 patients were included. Median time between first and last sample and last sample and event was 44.6(interquartile range [IQR]: 22.7-72.3) and 3.1(IQR: 1.4-6.4) months. Odds of death decreased by 46.0%(95% confidence interval [CI], 2.0-70.0, P=.04) for a 2-fold increase in latest 25(OH)D level. There was no association between 25(OH)D and the occurrence of AIDS or non-AIDS-defining events (P >.05). In patients with current 25(OH)D <10 ng/mL, hsIL-6 concentration increased by 4.7%(95% CI, .2,9.4, P = .04) annually after adjustment for immunological/inflammatory markers, and no change in hsCRP rate was observed (P = .76). Conclusions. Low Vitamin D predicts short term mortality in HIV-positive persons. Effectiveness of vitamin D supplementation on inflammation and patient outcomes should be investigated.


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<region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
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<sZ>4 aut.</sZ>
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<country>France</country>
<placeName>
<region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
</affiliation>
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<inist:fA14 i1="04">
<s1>INSERM, U938, Faculté de Médecine Saint Antoine, ICAN, Institute of Cardiometabolism and Nutrition</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>3 aut.</sZ>
<sZ>4 aut.</sZ>
<sZ>5 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName>
<region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
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<s1>UPMC Univ Paris 06, UMR_S 938</s1>
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<sZ>4 aut.</sZ>
<sZ>5 aut.</sZ>
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<country>France</country>
<placeName>
<region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
</placeName>
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</author>
<author>
<name sortKey="Reekie, Joanne" sort="Reekie, Joanne" uniqKey="Reekie J" first="Joanne" last="Reekie">Joanne Reekie</name>
<affiliation wicri:level="3">
<inist:fA14 i1="01">
<s1>Department of Infection and Population Health, University College London Medical School</s1>
<s2>London</s2>
<s3>GBR</s3>
<sZ>1 aut.</sZ>
<sZ>6 aut.</sZ>
<sZ>13 aut.</sZ>
</inist:fA14>
<country>Royaume-Uni</country>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
<affiliation wicri:level="1">
<inist:fA14 i1="06">
<s1>The Kirby Institute University of New South Wales</s1>
<s2>Sydney, New South Wales</s2>
<s3>AUS</s3>
<sZ>6 aut.</sZ>
</inist:fA14>
<country>Australie</country>
<wicri:noRegion>The Kirby Institute University of New South Wales</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Reiss, Peter" sort="Reiss, Peter" uniqKey="Reiss P" first="Peter" last="Reiss">Peter Reiss</name>
<affiliation wicri:level="4">
<inist:fA14 i1="07">
<s1>Academic Medical Centre (AMC), University of Amsterdam</s1>
<s2>Amsterdam</s2>
<s3>NLD</s3>
<sZ>7 aut.</sZ>
</inist:fA14>
<country>Pays-Bas</country>
<placeName>
<settlement type="city">Amsterdam</settlement>
<region nuts="2" type="province">Hollande-Septentrionale</region>
<settlement type="city">Amsterdam</settlement>
</placeName>
<orgName type="university">Université d'Amsterdam</orgName>
</affiliation>
</author>
<author>
<name sortKey="Blaxhult, Anders" sort="Blaxhult, Anders" uniqKey="Blaxhult A" first="Anders" last="Blaxhult">Anders Blaxhult</name>
<affiliation wicri:level="3">
<inist:fA14 i1="08">
<s1>Department of Medicine, Division of Infectious Diseases, Karolinska Institute</s1>
<s2>Stockholm</s2>
<s3>SWE</s3>
<sZ>8 aut.</sZ>
</inist:fA14>
<country>Suède</country>
<placeName>
<settlement type="city">Stockholm</settlement>
<region nuts="2">Svealand</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Bickel, Markus" sort="Bickel, Markus" uniqKey="Bickel M" first="Markus" last="Bickel">Markus Bickel</name>
<affiliation wicri:level="3">
<inist:fA14 i1="09">
<s1>HIVCENTER Haus 68</s1>
<s2>Frankfurt</s2>
<s3>DEU</s3>
<sZ>9 aut.</sZ>
</inist:fA14>
<country>Allemagne</country>
<placeName>
<region type="land" nuts="1">Hesse (Land)</region>
<region type="district" nuts="2">District de Darmstadt</region>
<settlement type="city">Francfort-sur-le-Main</settlement>
</placeName>
</affiliation>
</author>
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<name sortKey="Leen, Clifford" sort="Leen, Clifford" uniqKey="Leen C" first="Clifford" last="Leen">Clifford Leen</name>
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<inist:fA14 i1="10">
<s1>Edinburgh Regional Infectious Diseases Unit, Western General Hospital</s1>
<s2>Edinburgh</s2>
<s3>GBR</s3>
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</inist:fA14>
<country>Royaume-Uni</country>
<placeName>
<settlement type="city">Édimbourg</settlement>
<region type="country">Écosse</region>
</placeName>
</affiliation>
<affiliation wicri:level="3">
<inist:fA14 i1="11">
<s1>Edinburgh Infectious Diseases Edinburgh University</s1>
<s2>Edinburgh</s2>
<s3>GBR</s3>
<sZ>10 aut.</sZ>
</inist:fA14>
<country>Royaume-Uni</country>
<placeName>
<settlement type="city">Édimbourg</settlement>
<region type="country">Écosse</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Kirk, Ole" sort="Kirk, Ole" uniqKey="Kirk O" first="Ole" last="Kirk">Ole Kirk</name>
<affiliation wicri:level="3">
<inist:fA14 i1="12">
<s1>Copenhagen HIV Programme, University of Copenhagen</s1>
<s2>Copenhagen</s2>
<s3>DNK</s3>
<sZ>11 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>Danemark</country>
<placeName>
<settlement type="city">Copenhague</settlement>
<region type="région" nuts="2">Hovedstaden</region>
</placeName>
</affiliation>
<affiliation wicri:level="3">
<inist:fA14 i1="13">
<s1>Department of Infectious Diseases, Centre for Viral Diseases</s1>
<s2>Rigshospitalet, Copenhagen</s2>
<s3>DNK</s3>
<sZ>11 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>Danemark</country>
<placeName>
<settlement type="city">Copenhague</settlement>
<region type="région" nuts="2">Hovedstaden</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Lundgren, Jens D" sort="Lundgren, Jens D" uniqKey="Lundgren J" first="Jens D." last="Lundgren">Jens D. Lundgren</name>
<affiliation wicri:level="3">
<inist:fA14 i1="12">
<s1>Copenhagen HIV Programme, University of Copenhagen</s1>
<s2>Copenhagen</s2>
<s3>DNK</s3>
<sZ>11 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>Danemark</country>
<placeName>
<settlement type="city">Copenhague</settlement>
<region type="région" nuts="2">Hovedstaden</region>
</placeName>
</affiliation>
<affiliation wicri:level="3">
<inist:fA14 i1="13">
<s1>Department of Infectious Diseases, Centre for Viral Diseases</s1>
<s2>Rigshospitalet, Copenhagen</s2>
<s3>DNK</s3>
<sZ>11 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>Danemark</country>
<placeName>
<settlement type="city">Copenhague</settlement>
<region type="région" nuts="2">Hovedstaden</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Mocroft, Amanda" sort="Mocroft, Amanda" uniqKey="Mocroft A" first="Amanda" last="Mocroft">Amanda Mocroft</name>
<affiliation wicri:level="3">
<inist:fA14 i1="01">
<s1>Department of Infection and Population Health, University College London Medical School</s1>
<s2>London</s2>
<s3>GBR</s3>
<sZ>1 aut.</sZ>
<sZ>6 aut.</sZ>
<sZ>13 aut.</sZ>
</inist:fA14>
<country>Royaume-Uni</country>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Viard, Jean Paul" sort="Viard, Jean Paul" uniqKey="Viard J" first="Jean-Paul" last="Viard">Jean-Paul Viard</name>
<affiliation wicri:level="4">
<inist:fA14 i1="14">
<s1>Centre de Diagnostic et de Thérapeutique Hôtel-Dieu, APHP, and EA 3620, Université Paris Descartes</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>14 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName>
<region type="region">Île-de-France</region>
<region type="old region">Île-de-France</region>
<settlement type="city">Paris</settlement>
<settlement type="city">Paris</settlement>
</placeName>
<orgName type="university">Université Paris-Descartes</orgName>
</affiliation>
</author>
</analytic>
<series>
<title level="j" type="main">The Journal of infectious diseases</title>
<title level="j" type="abbreviated">J. infect. dis.</title>
<idno type="ISSN">0022-1899</idno>
<imprint>
<date when="2014">2014</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt>
<title level="j" type="main">The Journal of infectious diseases</title>
<title level="j" type="abbreviated">J. infect. dis.</title>
<idno type="ISSN">0022-1899</idno>
</seriesStmt>
</fileDesc>
<profileDesc>
<textClass>
<keywords scheme="KwdEn" xml:lang="en">
<term>AIDS</term>
<term>Human</term>
<term>Infection</term>
<term>Vitamin D</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr">
<term>Homme</term>
<term>Vitamine D</term>
<term>Infection</term>
<term>SIDA</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr">
<term>Homme</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">Background. Low 25-hydroxyvitamin D (25(OH)D) has been associated with inflammation, human immunodeficiency virus (HIV) disease progression, and death. We aimed to identify the prognostic value of 25(OH)D for AIDS, non-AIDS-defining events and death, and its association with immunological/inflammatory markers. Methods. Prospective 1-1 case-control study nested within the EuroSIDA cohort. Matched cases and controls for AIDS (n = 50 matched pairs), non-AIDS-defining (n = 63) events and death (n = 41), with plasma samples during follow-up were selected. Conditional logistic regression models investigated associations between 25(OH)D levels and annual 25(OH)D change and the probability of events. Mixed models investigated relationships between 25(OH)D levels and immunological/inflammatory markers. Results. In sum, 250 patients were included. Median time between first and last sample and last sample and event was 44.6(interquartile range [IQR]: 22.7-72.3) and 3.1(IQR: 1.4-6.4) months. Odds of death decreased by 46.0%(95% confidence interval [CI], 2.0-70.0, P=.04) for a 2-fold increase in latest 25(OH)D level. There was no association between 25(OH)D and the occurrence of AIDS or non-AIDS-defining events (P >.05). In patients with current 25(OH)D <10 ng/mL, hsIL-6 concentration increased by 4.7%(95% CI, .2,9.4, P = .04) annually after adjustment for immunological/inflammatory markers, and no change in hsCRP rate was observed (P = .76). Conclusions. Low Vitamin D predicts short term mortality in HIV-positive persons. Effectiveness of vitamin D supplementation on inflammation and patient outcomes should be investigated.</div>
</front>
</TEI>
<affiliations>
<list>
<country>
<li>Allemagne</li>
<li>Australie</li>
<li>Danemark</li>
<li>France</li>
<li>Pays-Bas</li>
<li>Royaume-Uni</li>
<li>Suède</li>
</country>
<region>
<li>Angleterre</li>
<li>District de Darmstadt</li>
<li>Grand Londres</li>
<li>Hesse (Land)</li>
<li>Hollande-Septentrionale</li>
<li>Hovedstaden</li>
<li>Svealand</li>
<li>Écosse</li>
<li>Île-de-France</li>
</region>
<settlement>
<li>Amsterdam</li>
<li>Copenhague</li>
<li>Francfort-sur-le-Main</li>
<li>Londres</li>
<li>Paris</li>
<li>Stockholm</li>
<li>Édimbourg</li>
</settlement>
<orgName>
<li>Université Paris-Descartes</li>
<li>Université d'Amsterdam</li>
</orgName>
</list>
<tree>
<country name="Royaume-Uni">
<region name="Angleterre">
<name sortKey="Shepherd, Leah" sort="Shepherd, Leah" uniqKey="Shepherd L" first="Leah" last="Shepherd">Leah Shepherd</name>
</region>
<name sortKey="Leen, Clifford" sort="Leen, Clifford" uniqKey="Leen C" first="Clifford" last="Leen">Clifford Leen</name>
<name sortKey="Leen, Clifford" sort="Leen, Clifford" uniqKey="Leen C" first="Clifford" last="Leen">Clifford Leen</name>
<name sortKey="Mocroft, Amanda" sort="Mocroft, Amanda" uniqKey="Mocroft A" first="Amanda" last="Mocroft">Amanda Mocroft</name>
<name sortKey="Reekie, Joanne" sort="Reekie, Joanne" uniqKey="Reekie J" first="Joanne" last="Reekie">Joanne Reekie</name>
</country>
<country name="France">
<region name="Île-de-France">
<name sortKey="Souberbielle, Jean Claude" sort="Souberbielle, Jean Claude" uniqKey="Souberbielle J" first="Jean-Claude" last="Souberbielle">Jean-Claude Souberbielle</name>
</region>
<name sortKey="Bastard, Jean Philippe" sort="Bastard, Jean Philippe" uniqKey="Bastard J" first="Jean-Philippe" last="Bastard">Jean-Philippe Bastard</name>
<name sortKey="Bastard, Jean Philippe" sort="Bastard, Jean Philippe" uniqKey="Bastard J" first="Jean-Philippe" last="Bastard">Jean-Philippe Bastard</name>
<name sortKey="Bastard, Jean Philippe" sort="Bastard, Jean Philippe" uniqKey="Bastard J" first="Jean-Philippe" last="Bastard">Jean-Philippe Bastard</name>
<name sortKey="Capeau, Jaqueline" sort="Capeau, Jaqueline" uniqKey="Capeau J" first="Jaqueline" last="Capeau">Jaqueline Capeau</name>
<name sortKey="Capeau, Jaqueline" sort="Capeau, Jaqueline" uniqKey="Capeau J" first="Jaqueline" last="Capeau">Jaqueline Capeau</name>
<name sortKey="Capeau, Jaqueline" sort="Capeau, Jaqueline" uniqKey="Capeau J" first="Jaqueline" last="Capeau">Jaqueline Capeau</name>
<name sortKey="Fellahi, Soraya" sort="Fellahi, Soraya" uniqKey="Fellahi S" first="Soraya" last="Fellahi">Soraya Fellahi</name>
<name sortKey="Fellahi, Soraya" sort="Fellahi, Soraya" uniqKey="Fellahi S" first="Soraya" last="Fellahi">Soraya Fellahi</name>
<name sortKey="Fellahi, Soraya" sort="Fellahi, Soraya" uniqKey="Fellahi S" first="Soraya" last="Fellahi">Soraya Fellahi</name>
<name sortKey="Viard, Jean Paul" sort="Viard, Jean Paul" uniqKey="Viard J" first="Jean-Paul" last="Viard">Jean-Paul Viard</name>
</country>
<country name="Australie">
<noRegion>
<name sortKey="Reekie, Joanne" sort="Reekie, Joanne" uniqKey="Reekie J" first="Joanne" last="Reekie">Joanne Reekie</name>
</noRegion>
</country>
<country name="Pays-Bas">
<region name="Hollande-Septentrionale">
<name sortKey="Reiss, Peter" sort="Reiss, Peter" uniqKey="Reiss P" first="Peter" last="Reiss">Peter Reiss</name>
</region>
</country>
<country name="Suède">
<region name="Svealand">
<name sortKey="Blaxhult, Anders" sort="Blaxhult, Anders" uniqKey="Blaxhult A" first="Anders" last="Blaxhult">Anders Blaxhult</name>
</region>
</country>
<country name="Allemagne">
<region name="Hesse (Land)">
<name sortKey="Bickel, Markus" sort="Bickel, Markus" uniqKey="Bickel M" first="Markus" last="Bickel">Markus Bickel</name>
</region>
</country>
<country name="Danemark">
<region name="Hovedstaden">
<name sortKey="Kirk, Ole" sort="Kirk, Ole" uniqKey="Kirk O" first="Ole" last="Kirk">Ole Kirk</name>
</region>
<name sortKey="Kirk, Ole" sort="Kirk, Ole" uniqKey="Kirk O" first="Ole" last="Kirk">Ole Kirk</name>
<name sortKey="Lundgren, Jens D" sort="Lundgren, Jens D" uniqKey="Lundgren J" first="Jens D." last="Lundgren">Jens D. Lundgren</name>
<name sortKey="Lundgren, Jens D" sort="Lundgren, Jens D" uniqKey="Lundgren J" first="Jens D." last="Lundgren">Jens D. Lundgren</name>
</country>
</tree>
</affiliations>
</record>

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