TITLE:
Deficiency of Vitamin D in HIV Infected Patients and Its Effect on Some of the Immunological Parameters
AUTHORS:
Nina Yancheva, Ivaylo Elenkov, Tatyana Tchervenyakova, Ivanka Gabarska, Georgi Kirilov, Maria Nikolova, Marina Alexandrova
KEYWORDS:
HIV, Vitamin D, Deficiency, Cytokines, Immune Activation
JOURNAL NAME:
World Journal of AIDS,
Vol.5 No.3,
September
7,
2015
ABSTRACT: Today the HIV infection is a chronic
disease with significantly longer duration of the life of the patients.
Problems of pressing interest are the persistent immune activation and chronic
inflammation during the treatment with antiretroviral therapy. Taking this
into account, different factors which could affect the immune system and the
progress of the HIV infection are being researched. Vitamin D (25(OH)D) is one
of those factors if we take note of its effect on the innate and acquired
immunity. The aim of this study was to assess 25-hydroxyvitamin D (vitamin D)
status in one part of the Bulgarian HIV-infected adult population and to assess
connection between 25-hydroxyvitamin D (vitamin D) status and plasma levels
of some major cytokines (IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ). The study
includes 145 HIV-positive patients, who are being monitored in the Department
for acquired immune deficiency at Specialized Hospital for Infectious and
Parasitic Diseases “Proff. Ivan Kirov”—Sofia. From all of the monitored
patients only in 15% of the tested we found normal 25(OH)D serum levels, and in
12% of the patients we found deficiency. The largest group is that of patients
with insufficiency of vitamin D. We didn’t discovered significant difference in
the 25(OH)D average values between men and women. There were no significant
differences in the average values of the 25(OH)D serum levels when dividing the
patients according to their antiretroviral therapy, but after separating the
patients by gender, we found that the untreated women had average values of
25(OH)D higher than that of the women treated with EFV. On the next stage of
the survey on the 60 HIV-infected patients, who are from the first tested
group, we additionally defined the cytokine profile. Our results suggests that
increasing 25(OH)D deficiency worsens the damaging of the cellular immune
response. The lower levels of vitamin Dare associated with increased levels of
IL-6, decreased levels of IL-10, IFN-γ and TNF-α. There’s active immune
inflammation when there are reduced 25(OH)D serum levels and it leads to
stimulated secretion of the regulatory cytokines and suppression of the Th1
antiviral response. The phase of advanced 25(OH)D deficiency is characterized
by parallel depletion of the regulatory and effecter capabilities of CD4
lymphocytes. The recovery of the CD4 lymphocyte pool is difficult because of
the lower than average 25(OH)D serum levels, regardless of the conducted
antiretroviral therapy.