Background
Vitamin D deficiency is common in HIV-infected individuals. In adults, traditional and HIV-related factors play a role in vitamin D status, and deficiency appears to impair immune restoration and exacerbate HIV complications, like cardiovascular disease (CVD). This study sought to determine factors contributing to vitamin D status in HIV-infected youth and investigate the relationship with CVD risk, inflammation, and immune restoration.
Methods
HIV-infected subjects (1–25 years old) were enrolled prospectively along with healthy controls that were group-matched by age, sex, and race. HIV data were collected for the HIV-infected group, while traditional risk factors, including vitamin D intake, sun exposure, skin pigmentation, physical activity level, and body mass index (BMI) were collected for both groups. Fasting lipids, plasma 25-hydroxyvitamin D (25(OH)D), and inflammation markers were measured.
Results
200 HIV-infected subjects and 50 controls were enrolled. HIV group had 53% male, 95% black, and a mean age of 17.2±4.6 years. There was no difference in 25(OH)D between groups; 77% of HIV+ and 74% of controls had 25(OH)D <20 ng/mL. Only Fitzpatrick skin type was independently associated with 25(OH)D. No HIV variables were associated with 25(OH)D, even when HIV sub-populations were examined. Inflammation, CVD risk factors, and immune restoration were not independently associated with 25(OH)D.
Conclusions
Vitamin D deficiency is common among HIV-infected youth. However, HIV factors, CVD risk, inflammation, and immune restoration do not appear to have the same relationship with vitamin D as has been shown in adults. Supplementation trials are needed to determine if increasing 25(OH)D concentrations could better elucidate these relationships.