Vitamin D Deficiency Linked With Diminished CD4 Recovery After cART Initiation

Baseline vitamin D deficiency may be associated with diminished CD4 recovery in HIV-positive patients after initiation of combination antiretroviral therapy (cART), according to findings published in Clinical Nutrition.

Although both nutritional status and inflammation can affect the number of CD4 cells and their function, the association with CD4 recovery in HIV-positive adults following cART initiation has not been well studied.

In this study, the authors examined the association between micronutrients, including selenium, vitamin D, vitamin A, and inflammation biomarkers with CD4 recovery following cART initiation.

A secondary analysis was conducted using data derived from 270 participants in the randomized PEARLS trial of cART regimen efficacy (ClinicalTrials.gov Identifier: NCT00084136), in which serum levels of micronutrients and inflammatory biomarkers were measured prior to initiation of cART.

Vitamin D deficiency before cART initiation was associated with lower CD4 recovery (14.9 cells/mm³; 95% CI, 27.9-1.8) vs sufficient levels, whereas baseline selenium deficiency (20.8 cells/mm³; 95% CI, 3.3-38.3), vitamin A deficiency (35.9 cells/mm³; 95% CI, 17.6-54.3), and high soluble CD14 (23.4 cells/mm³; 95% CI, 8.9-37.8) were associated with higher CD4 recovery vs sufficient/low inflammation status.

“While more investigation is needed, our findings suggest that correcting baseline deficiency of vitamin D may improve CD4 recovery,” write the authors.

Reference

Shivakoti R, Ewald ER, Gupte N, et al. Effect of baseline micronutrient and inflammation status on CD4 recovery post-cART initiation in the multinational PEARLS trial [published online May 29, 2-18]. Clin Nutr. doi: 10.1016/j.clnu.2018.05.014