Change in vitamin D levels occurs early after antiretroviral therapy initiation and depends on treatment regimen in resource-limited settings

dc.creatorHavers, Fiona P.
dc.creatorDetrick, Barbara
dc.creatorCardoso, Sandra Wagner
dc.creatorBerendes, Sima
dc.creatorLama, Javier R.
dc.creatorSugandhavesa, Patcharaphan
dc.creatorMwelase, Noluthando H.
dc.creatorCampbell, Thomas B.
dc.creatorGupta, Amita
dc.date2015-06-08T16:50:13Z
dc.date2015-06-08T16:50:13Z
dc.date2014
dc.date.accessioned2023-09-26T21:04:36Z
dc.date.available2023-09-26T21:04:36Z
dc.identifierHAVERS, Fiona P. et al. Change in vitamin D levels occurs early after antiretroviral therapy initiation and depends on treatment regimen in resource-limited settings. Plos One, v. 9, n. 4, p. 1-9, 2014.
dc.identifier1932-6203
dc.identifierhttps://www.arca.fiocruz.br/handle/icict/10735
dc.identifier10.1371/journal.pone.0095164
dc.identifier1932-6203
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8868758
dc.descriptionAIDS Clinical Trials Group, US National Institute of Allergy and Infectious Diseases, US National Institutes of Health, Boehringer-Ingelheim, Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline
dc.descriptionStudy Background: Vitamin D has wide-ranging effects on the immune system, and studies suggest that low serum vitamin D levels are associated with worse clinical outcomes in HIV. Recent studies have identified an interaction between antiretrovirals used to treat HIV and reduced serum vitamin D levels, but these studies have been done in North American and European populations. Methods: Using a prospective cohort study design nested in a multinational clinical trial, we examined the effect of three combination antiretroviral (cART) regimens on serum vitamin D levels in 270 cART-naı¨ve, HIV-infected adults in nine diverse countries, (Brazil, Haiti, Peru, Thailand, India, Malawi, South Africa, Zimbabwe and the United States). We evaluated the change between baseline serum vitamin D levels and vitamin D levels 24 and 48 weeks after cART initiation. Results: Serum vitamin D levels decreased significantly from baseline to 24 weeks among those randomized to efavirenz/lamivudine/zidovudine (mean change: 27.94 [95% Confidence Interval (CI) 210.42, 25.54] ng/ml) and efavirenz/ emtricitabine/tenofovir-DF (mean change: 26.66 [95% CI 29.40, 23.92] ng/ml) when compared to those randomized to atazanavir/emtricitabine/didanosine-EC (mean change: 22.29 [95% CI –4.83, 0.25] ng/ml). Vitamin D levels did not change significantly between week 24 and 48. Other factors that significantly affected serum vitamin D change included country (p,0.001), season (p,0.001) and baseline vitamin D level (p,0.001). Conclusion: Efavirenz-containing cART regimens adversely affected vitamin D levels in patients from economically, geographically and racially diverse resource-limited settings. This effect was most pronounced early after cART initiation. Research is needed to define the role of Vitamin D supplementation in HIV care.
dc.formatapplication/pdf
dc.languageeng
dc.publisherPublic Library of Science
dc.rightsopen access
dc.subjectVitamin D
dc.subjectAntiretroviral Therapy
dc.subjectHIV
dc.subjectStatistical Analysis
dc.subjectHighly Active
dc.subjectVitamina D
dc.subjectTerapia Antirretroviral de Alta Atividade
dc.subjectHIV
dc.subjectAnálise Estatística
dc.titleChange in vitamin D levels occurs early after antiretroviral therapy initiation and depends on treatment regimen in resource-limited settings
dc.typeArticle


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