Research paper
Vitamin D and HIV Progression among Tanzanian Adults Initiating Antiretroviral Therapy
Study answer
What this study found
Vitamin D deficiency at ART initiation (<20 ng/mL) was associated with two-fold higher risk of all-cause mortality vs sufficiency (>30 ng/mL) after adjustment (HR 2.00; 95% CI 1.19-3.37; P = 0.009). Vitamin D insufficiency (20-30 ng/mL) showed no significant mortality increase (HR 1.24; 95% CI 0.87-1.78; P = 0.24). Vitamin D status did not affect change in CD4 T-cell count after ART initiation. A non-linear relationship observed with continuous 25(OH)D, with mortality risk rising below ~25 ng/mL and little additional benefit above ~30 ng/mL. No significant interaction by ART regimen or…
- Study & population
- Prospective cohort nested within a double-blind, randomized controlled trial; HIV-infected adults aged 18+ initiating ART in Dar es Salaam, Tanzania; both men and women; not pregnant; recruited from seven centers; baseline vitamin D (25(OH)D) measured.
- Intervention
- Daily oral supplements of vitamins B-complex, C, and E at high versus standard levels of the recommended dietary allowance (RDA).
- Key limitation
- 25(OH)D measured at a single baseline timepoint; observational design limits causal inference; limited generalizability to pregnant women or children on ART; potential reverse causation; residual confounding (e.g., TB, hepatitis C) not fully accounted; limited power to detect interactions by ART or multivitamin…
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Open PDFOriginal abstract
Background There is growing evidence of an association between low vitamin D and HIV disease progression; however, no prospective studies have been conducted among adults receiving antiretroviral therapy (ART) in sub-Saharan Africa. Methods Serum 25-…