Effects of Cholecalciferol Supplementation on Serum and Urinary Vitamin D Metabolites and Binding Protein in HIV-infected Youth

• Type of Material: Article
• Authors: Allison Ross Eckard, Emory University; Myrtle Thierry-Palmer, Morehouse School of Medicine; Natalia Silvestrov, Morehouse School of Medicine; Julia C. Rosebush, Emory University; Mary Ann O'Riordan, Case Western Reserve University; Julie E. Daniels, Emory University; Monika Uribe-Leitz, Emory University; Danielle Labbato, Case Western Reserve University; Joshua H. Ruff, Emory University; Ravinder J. Singh, Mayo Clinic; Vin Tangpricha, Emory University; Grace A. McComsey, Case Western Reserve University
• Language: English
• Date: 2017-04-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017 Elsevier Ltd
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jsbmb.2017.01.018
• Title of Journal or Parent Work: Journal of Steroid Biochemistry and Molecular Biology
• ISSN: 0960-0760
• Volume: 168
• Start Page: 38
• End Page: 48
• Grant/Funding Information: Case Western Reserve University’s Center for AIDS Research (P30 AI36219), Emory University’s Center for AIDS Research (P30 AI050409), Emory+Children’s Pediatric Research Center (Immunology Cores), Clinical and Translational Science Award and the Clinical and Translational Science Collaborative of Cleveland (UL1TR000439) from the National Center for Advancing Translational Sciences (NCATS) component of the National Institutes of Health and NIH roadmap for Medical Research.; This work was made possible by the National Institute of Child Health and Development at the National Institutes of Health [K23 HD069199 to ARE; R01 HD070490 to GAM], National Institutes of Health/Clinical Research Center Grant [8G12MD007602-27 to Morehouse School of Medicine].
• Keywords: Vitamin D; HUMAN-IMMUNODEFICIENCY-VIRUS; Cholecalciferol supplementation; D DEFICIENCY; INTIMA-MEDIA THICKNESS; Vitamin d binding protein; Vitamin d metabolites; Biochemistry & Molecular Biology; Endocrinology & Metabolism; Science & Technology; CARDIOVASCULAR RISK-FACTORS; Pediatrics and adolescents; PERINATALLY ACQUIRED HIV; HIV; YOUNG-ADULTS; Randomized-controlled trial; PLACEBO-CONTROLLED TRIAL; ANTIRETROVIRAL THERAPY; 25-HYDROXYVITAMIN D; GENERAL-POPULATION; Life Sciences & Biomedicine
• Research Categories: Chemistry, Biochemistry; Health Sciences, General

Abstract

Vitamin D insufficiency is widespread in HIV-infected patients. HIV and/or antiretroviral therapy (ART), particularly efavirenz (EFV), may interfere with vitamin D metabolism. However, few data from randomized, controlled trials exist. Here, we investigate changes in vitamin D metabolites and binding protein (VDBP) after 6 months of supplementation in a randomized, active-control, double-blind trial investigating 2 different monthly cholecalciferol (vitamin D 3 ) doses [60,000 (medium) or 120,000 (high) IU/month] vs. a control arm of 18,000 IU/month in 8–25 year old HIV-infected youth on ART with HIV-1 RNA < 1000 copies/mL and baseline 25-hydroxycholecalciferol (25(OH)D 3 ) ≤30 ng/mL. A matched healthy uninfected group was enrolled in a similar parallel study for comparison. Changes after 6 months were analyzed as intent-to-treat within/between groups [control group (low dose) vs. combined supplementation doses (medium + high)]. At 6 months, 55% vs. 82% of subjects in control and supplementation groups, respectively, reached 25(OH)D 3 ≥30 ng/mL (P = 0.01) with no difference between medium and high doses (both 82% ≥30 ng/mL). There were few differences for those on EFV vs. no-EFV, except serum VDBP decreased in EFV-treated subjects (both within- and between-groups P ≤ 0.01). There were no significant differences between the HIV-infected vs. healthy uninfected groups. The major finding of the present study is that cholecalciferol supplementation (60,000 or 120,000 IU/month) effectively raises serum 25(OH)D 3 in the majority of HIV-infected subjects, regardless of EFV use. Notably, response to supplementation was similar to that of uninfected subjects.