Vitamin D deficiency is associated with neurocognitive impairment in HIV-infected subjects
Infection, pp 1–7 https://doi.org/10.1007/s15010-019-01313-6
Alessandra VergoriCarmela PinnettiEmail authorPatrizia LorenziniAnnaClelia BritaRaffaella LibertoneIlaria MastrorosaStefania CicaliniAndrea AntinoriAdriana Ammassari
HIV category listing contains the following
Pregnant women in HIV therapy adding Vitamin D had 3X fewer deaths - RCT April 2022
HIV treatment augmented by high-dose vitamin D, daily or weekly – Dec 2021
Low vitamin D with HIV increases risk of infections – TB by 3.5X, CMV by 10.1X – Aug 2020
HIV therapy reduces Vitamin D levels, supplementation helps - Nov 2019
Cognitive problems 2X more likely if HIV and low vitamin D – June 2019
Use of Tenofovir disoproxil fumarate (Hepatitis-B, AIDS) requires more vitamin D – Sept 2018
Vertebral fractures 9X more likely in HIV patients having low vitamin D – Dec 2017
HIV patients helped by monthly 120,000 IU of Vitamin D – RCT Oct 2017
Those with HIV who doubled their vitamin D levels reduced their chance of death by 47 percent – Oct 2013
A gut-friendly form of vitamin D should be used for those with HIV and gut problems
Alternately, just use 2X to 3X more vitamin D than for a person who has a good gut
3X more African girls and women have HIV than African males Washington Post Dec 2023
Note: Many women have lower vitamin D levels than men due to hormones and not being outdoors as much
In addition, dark-skinned women often avoid the sun due to a desire to have a lighter skin shade
Purpose
Low vitamin D levels are associated with higher odds of cognitive dysfunction in the older population, and in subjects with mental disorders or with chronic neurologic diseases. With combination antiretroviral therapy (cART), incidence of HIV-associated dementia has reduced, while the prevalence of milder forms of neurocognitive impairment (NCI) persisted stable over time. Hypovitaminosis D is often found in HIV infection but its association with NCI has not been investigated yet. The aim was to explore this association in a clinic-based HIV-positive population.
Methods
A retrospective, cross-sectional analysis of an existing monocenter dataset obtained from patients undergoing neuropsychological assessment in routine clinical care between January, 2011 and December, 2016 was carried out. NCI was assessed through a standardized battery of 13 tests on 5 different cognitive domains and HIV-associated neurocognitive deficit (HAND) was classified according to Frascati’s criteria. Vitamin D deficiency was defined by 25 hydroxy-vitamin D 25(OH)D levels < 10 ng/mL. Logistic regression was adjusted for main associated covariates and seasonality.
Results
542 patients were included: 96.7% were receiving cART, median CD4 count was 611/mmc (IQR, 421–809), HIV RNA was < 40 cp/mL in 85.8%. Median 25(OH)D was 23.2 ng/mL (IQR, 15.6–29.2), with vitamin D insufficiency 67.7% and deficiency in 9.4%. Overall, NCI was found in 37.1% and HAND in 22.7%. Compared to patients with higher vitamin D levels, subjects with vitamin D deficiency had increased proportions of NCI (52.9% versus 35.4%; p = 0.014) or of HAND (42.9% versus 24.9%; p = 0.012). Median NPZ-8 scores were significantly different based on vitamin D levels (p = 0.021).
At multivariable analyses, vitamin D deficiency was the only risk factor of
- NCI (OR 2.05; 95% CI 1.04–4.05; p = 0.038) or of
- (HAND (OR 2.12; 95% CI 0.99–4.54; p = 0.052).
Conclusions
In HIV-positive persons, severe hypovitaminosis D was independently associated with a higher risk of neurocognitive impairment in general, and of HIV-associated neurocognitive disorders in particular. Future studies are needed to elucidate causal relationship and whether vitamin D supplementation may reverse this risk.
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