Studies on Vitamin D Levels in Serum of HIV Infected Patients: Their Effect on Progression towards AIDS


Vitamin D deficiency may be more prevalent among HIV-positive patients than in the general population due to HIV disease-related factors. This study examined the effects of HIV infection and use of antiretroviral drugs in serum vitamin D levels in HIV patients visiting Aga Khan University Hospital, Nairobi Kenya from October 2013 to April 2014. The effect of vitamin D status on CD4 cell count and HIV viral load was evaluated to determine the status of disease progression to AIDS. HIV viral load in blood samples was determined using COBAS Ampliprep/TaqMan HIV-1 test kit while CD4 cell counts were done using the fluorescence-activated cell sorter system. The levels of vitamin D in serum were determined using electrochemiluminescence binding assay in Cobas E601 mass analyzers. In addition, selected plasma enzymes were used to evaluate liver function. Higher percentage (49.12%) of deficient vitamin D cases were observed among HIV patients not on ART. Deficient levels of Vitamin D were associated with abnormal selected liver enzymes. High viral load was observed among patients not on ART with deficient and insufficient vitamin D. The CD4 cell count was higher in patients on ART with sufficient vitamin D levels compared to those with deficient vitamin D. These observations suggest a need to supplement ART with vitamin D in order to ameliorate Vitamin D deficiency as a strategy to improve HIV management.

Share and Cite:

Gichuhi, C. , Kariuki, D. , Nyerere, A. and Riyat, M. (2014) Studies on Vitamin D Levels in Serum of HIV Infected Patients: Their Effect on Progression towards AIDS. World Journal of AIDS, 4, 422-429. doi: 10.4236/wja.2014.44050.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Mehta, S., Giovannucci, E., Mugusi, M., Spiegelman, D., Aboud, S., Hertzmark, E., et al. (2010) Vitamin D Status of HIV-Infected Women and Its Association with HIV Disease Progression, Anemia, and Mortality. PLOS ONE, 5, e8770.
[2] Holick, M.F. (2007) Vitamin D Deficiency. New England Journal of Medicine, 357, 266-281.
[3] Haug, C., Muller, F., Aukrust, P. and Froland, S.S. (1994) Subnormal Serum Concentration of 1, 25-Vitamin D in Human Immunodeficiency Virus Infection: Correlation with Degree of Immune Deficiency and Survival. Journal of Infectious Diseases, 169, 889-893.
[4] Fawzi, W.W., Msamanga, G.I., Spiegelman, D., Wei, R. and Kapiga, S. (2004) A Randomized Trial of Multivitamin Supplements and HIV Disease Progression and Mortality. New England Journal of Medicine, 351, 23-32.
[5] Melamed, M.L., Michos, E.D., Post, W. and Astor, B. (2008) 25-Hydroxyvitamin D Levels and the Risk of Mortality in the General Population. Archives of Internal Medicine, 168, 1629-1637.
[6] Van Den Bout Van Den Beukel, C.J., Fievez, L., Michels, M., Sweep, F.C., Hermus, A.R., Bosch, M.E., et al. (2008) Vitamin D Deficiency among HIV Type 1-Infected Individuals in the Netherlands: Effects of Antiretroviral Therapy. AIDS Research and Human Retroviruses, 24, 1375-1382.
[7] Yin, M. and Stein, E. (2011) The Effect of Antiretrovirals on Vitamin D. Clinical Infectious Diseases, 52, 406-408.
[8] Childs, K., Welz, T., Samarawickrama, A. and Post, F.A. (2012) Effects of Vitamin D Deficiency and Combination Antiretroviral Therapy on Bone in HIV-Positive Patients. AIDS, 26, 253-262.
[9] Allavena, C., Delpierre, C., Cuzin, L., Rey, D., Viget, N., et al. (2012) High Frequency of Vitamin D Deficiency in HIV-Infected Patients: Effects of HIV-Related Factors and Antiretroviral Drugs. Journal of Antimicrobial Chemotherapy, 67, 2222-2230.
[10] Fox, J., Peters, B., Prakash, M., Arribas, J., Hill, A., et al. (2011) Improvement in Vitamin D Deficiency Following Antiretroviral Regime Change: Results from the MONET Trial. AIDS Research and Human Retroviruses, 27, 29-34.
[11] Cheng, J.B., Levine, M.A., Bell, N.H., Mangelsdorf, D.J. and Russell, D.W. (2004) Genetic Evidence That the Human CYP2R1 Enzyme Is a Key Vitamin D 25-Hydroxylase. Proceedings of the National Academy of Sciences of the USA, 101, 7711-7715.
[12] Zhou, C., Assem, M., Tay, J.C., Watkins, P.B., Blumberg, B., et al. (2006) Steroid and Xenobiotic Receptor and Vitamin D Receptor Crosstalk Mediates CYP24 Expression and Drug-Induced Osteomalacia. Journal of Clinical Investigation, 116, 1703-1712.
[13] Woodward, C., Hall, A., William, I., et al. (2009) Tenofovir-Associated Renal and Bone Toxicity. HIV Medication, 10, 482-487.
[14] Peyriere, H., Reynes, J., Rouanet, I., et al. (2004) Renal Tubular Dysfunction Associated with Tenofovir Therapy. Journal of Acquired Immune Deficiency Syndromes, 35, 269-273.
[15] Allison, C.R., Suzanne, J., Meena, K., Corrynn, H., Norma, S., Daniella, L.T. and Grace, A.M. (2011) Vitamin D Linked to Carotid Intima-Media Thickness and Immune Reconstitution in HIV-Positive Individuals. Antiviral Therapy, 16, 555-563.
[16] de Luis, D.A., Bachiller, P., Aller, R., et al. (2002) Relation among Micronutrient Intakes with CD4 Count in HIV Infected Patients. Nutricion Hospitalaria, 17, 285-289.
[17] Kim, J.H., Gandhi, V., Psevdos Jr., G., Espinoza, F., Park, J. and Sharp, V. (2011) Evaluation of Vitamin D Levels among HIV-Infected Patients in New York City. AIDS Research and Human Retroviruses, 28, 235-241.
[18] Zanetti, M. (2004) Cathelicidins, Multifunctional Peptides of the Innate Immunity. Journal of Leukocyte Biology, 75, 39-48.
[19] Zhang, Y., Shi, W., Tang, S., Li, J., Yin, S., Gao, X., Wang, L., Zou, L., Zhao, J., Huang, Y., Shan, L., Gounni, A.S., Wu, Y., Yuan, F. and Zhang, J. (2013) The Influence of Cathelicidin LL37 in Human Anti-Neutrophils Cytoplasmic Antibody (ANCA)-Associated Vasculitis. Arthritis Research Therapy, 15, R161.
[20] Heilborn, J.D., Nilsson, M.F., Chamorro Jimenez, C.I., Sandstedt, B., Borregaard, N., Tham, E., S?rensen, O.E., Weber, G. and St?hle, M. (2005) Antimicrobial Protein hCAP18/ LL-37 Is Highly Expressed in Breast Cancer and Is a Putative Growth Factor for Epithelial Cells. International Journal of Cancer, 114, 713-719.
[21] Wang, G., Watson, K.M. and Buckheit Jr., R.W. (2008) Anti-Human Immunodeficiency Virus Type 1 Activities of Antimicrobial Peptides Derived from Human and Bovine Cathelicidins. Antimicrobial Agents and Chemotherapy, 52, 3438-3440.
[22] Bergman, N., Moraes, K., Anderson, J., Zaric, B., Kambach, C., Schneider, R., et al. (2007) Lsm Proteins Bind and Stabilize RNAs Containing 5’ Poly(A) Tracts. Nature Structural Molecular Biology, 14, 824-831.
[23] Ginde, A.A., Mansbach, J.M. and Camargo Jr., C.A. (2009) Association between Serum 25-Hydroxyvitamin D Level and Upper Respiratory Tract Infection in the Third National Health and Nutrition Examination Survey. Archives of Internal Medicine, 169, 384-390.
[24] Laaksi, I., Ruohola, J.P., Tuohimaa, P., Auvinen, A., Haataja, R., Pihlajam?ki, H. and Ylikomi, T. (2007) An Association of Serum Vitamin D Concentrations < 40 nmol/L with Acute Respiratory Tract Infection in Young Finnish Men. The American Journal of Clinical Nutrition, 86, 714-717.
[25] Schwartz, J.B., Moore, K.L., Yin, M., Sharma, A., Merenstein, D., Islam, T., Golub, E.T., Tien, P.C. and Adeyemi, O.M. (2014) Study of HIV-Infected and Uninfected Women in the United States Relationship of Vitamin D, HIV, HIV Treatment, and Lipid Levels in the Women’s Interagency HIV. JIAPAC, 13, 250.
[26] Rook, G.A., Steele, J., Fraher, L., Barler, S., Karmali, R., O’Riordan, J. and Stanford, J. (1986) Vitamin D3, Gamma Interferon, and Control of Proliferation of Mycobacterium tuberculosis by Human Monocytes. Immunology, 57, 159-163.
[27] Mata, M.J., Gaytán, M.J., Grados-Chavarría, B.H., Fuentes-Allen, J.L., Arroyo-Anduiza, C.I. and Alfaro-Mejía, A. (2009) Correlation between HIV Viral load and Aminotransferases as Liver Damage Markers in HIV Infected Naive Patients: A Concordance Cross-Sectional Study. Virology Journal, 6, 181.
[28] Dalla, P.M., Amorosa, V.K., Localio, R., Kostman, J.R. and Lo Re, V. (2010) Prevalence and Risk Factors for Significant Liver Fibrosis among HIV-Monoinfected Patients. BMC Infectious Diseases, 10, 116.
[29] Crum, C.N., Grandits, G., Echols, S., Ganesan, A., Landrum, M., Weintrob, A., Barthel, R. and Agan, B. (2010) Trends and Causes of Hospitalizations among HIV-Infected Persons during the Late HAART Era: What Is the Impact of CD4 Counts and HAART Use? Journal of Acquired Immune Deficiency Syndromes, 54, 248-257.

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.