Author | Havers, Fiona P. | |
Author | Detrick, Barbara | |
Author | Cardoso, Sandra W. | |
Author | Berendes, Sima | |
Author | Lama, Javier R. | |
Author | Sugandhavesa, Patcharaphan | |
Author | Mwelase, Noluthando H. | |
Author | Campbell, Thomas B. | |
Author | Gupta, Amita | |
Access date | 2015-06-08T16:50:13Z | |
Available date | 2015-06-08T16:50:13Z | |
Document date | 2014 | |
Citation | HAVERS, 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, Apr. 2014. | pt_BR |
ISSN | 1932-6203 | |
URI | https://www.arca.fiocruz.br/handle/icict/10735 | |
Description | Membership of the ACTG A5175 PEARLS study and NWCS 319 Study Teams is provided in the Acknowledgments. | |
Sponsorship | This work was supported by the AIDS Clinical Trials Group and was funded by the US National Institute of Allergy and Infectious Diseases [AI68636, AI069450] and by additional grants from the US National Institutes of Health [R01 AI45462 to AG and T32 AI007291 to FH]. This research was also supported in part by Boehringer-Ingelheim, Bristol-Myers Squibb, Gilead Sciences, and GlaxoSmithKline. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. | |
Language | eng | pt_BR |
Publisher | Public Library of Science | pt_BR |
Rights | open access | pt_BR |
Title | Change in vitamin D levels occurs early after antiretroviral therapy initiation and depends on treatment regimen in resource-limited settings | pt_BR |
Type | Article | pt_BR |
DOI | 10.1371/journal.pone.0095164 | |
Abstract | Study 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. | pt_BR |
Affilliation | Johns Hopkins University School of Medicine. Baltimore, MD, USA / Johns Hopkins University Bloomberg School of Public Health. Baltimore, MD, USA. | pt_BR |
Affilliation | Johns Hopkins University School of Medicine. Baltimore, MD, USA. | pt_BR |
Affilliation | Fundação Oswaldo cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST e AIDS. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | College of Medicine-Johns Hopkins University Research Project. Blantyre, Malawi / Liverpool School of Tropical Medicine. Liverpool, United Kingdom. | pt_BR |
Affilliation | Asociacion Civil Impacta Salud y Educacion. Lima, Peru. | pt_BR |
Affilliation | Chiang Mai University. Chiang Mai, Thailand. | pt_BR |
Affilliation | University of Witswatersrand. Johannesburg, South Africa. | pt_BR |
Affilliation | University of Colorado Denver. Aurora, CO, USA. | pt_BR |
Affilliation | Johns Hopkins University School of Medicine. Baltimore, MD, USA / Johns Hopkins University Bloomberg School of Public Health. Baltimore, MD, USA. | pt_BR |
Subject | Vitamin D | pt_BR |
Subject | Antiretroviral Therapy | pt_BR |
Subject | HIV | pt_BR |
Subject | Statistical Analysis | pt_BR |
Subject | Highly Active | pt_BR |
e-ISSN | 1932-6203 | |