The effect of vitamin D supplementation on increasing CD4 levels in human immunodeficiency virus

evidence-based report

  • Dessy Suci Rachmawati Faculty of Medicine, , Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
  • Diana Sunardi Faculty of Medicine, , Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
Keywords: vitamin D supplementation, CD4, human immunodeficiency virus

Abstract

Introduction: Human immunodeficiency virus (HIV) is a retrovirus infection that attacks the immune system. According to world data in 2016, the number of HIV-infected patients reached 36.7 million, and 10 million people died due to acquired immunodeficiency syndrome (AIDS). Patients with HIV infection are susceptible to decreased levels of vitamin D (25(OH)D) by proinflammatory cytokines or as a result of the use of antiretroviral drugs. Vitamin D plays an important role in immune system, including reducing the production of pro-inflammatory cytokines and increasing the production of cathelicidin that inhibit viral replication. Oral vitamin D supplementation is an effort that can be made to increase vitamin D. To date, the relationship between vitamin D sufficiency and CD4 T cell count remains unclear, although most studies have shown a positive association. This study wanted to determine the effect of oral vitamin D supplementation on increasing CD4 levels in patients with HIV infection. Methods: Literature search was carried out by advanced searching on Pubmed, Cochrane Library, and Science Direct using eligibility criteria determined by the authors. Result: One systematic review and three randomized controlled trials (RCT) met the PICO and eligibility criteria that had been set. Three studies concluded that vitamin D supplementation can increase CD4 levels. One study shows that vitamin D supplementation dose of 5,000 IU daily could not increase CD4 levels. Conclusion: Providing vitamin D supplementation at appropriate dose can increase serum vitamin D levels so that it can increase CD4 levels.

Downloads

Download data is not yet available.

Author Biographies

Dessy Suci Rachmawati, Faculty of Medicine, , Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
Department of Nutrition
Diana Sunardi, Faculty of Medicine, , Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
Department of Nutrition

References

Lake JE, Adams JS. Vitamin D in HIV-Infected Patients. Curr HIV/AIDS Rep. 2011 Sep;8(3):133-41.

Shepherd L, Souberbielle JC, Bastard JP, Fellahi S, Capeau J, Reekie J, Reiss P, Blaxhult A, Bickel M, Leen C, Kirk O, Lundgren JD, Mocroft A, Viard JP. Prognostic Value of Vitamin D Level for All-cause Mortality, and Association With Inflammatory Markers, in HIV-infected Persons. Journal of Infectious Diseases. 2014; 210(2): 234–43.

Rehman AM, Woodd SL, Heimburger DC, Koethe JR, Friis H, Praygod G, et al. Changes in serum phosphate and potassium and their effects on mortality in malnourished African HIV-infected adults starting antiretroviral therapy and given vitamins and minerals in lipid-based nutritional supplements: secondary analysis from the Nutritional Support for African Adults Starting Antiretroviral Therapy (NUSTART) trial. Br J Nutr 2017;117(6):814-21

Smith CL, Stein GE. Viral load as a surrogate end point in HIV disease. Ann. Pharmacother. 2002; 36: 280–87

Ao T, Kikuta J, Ishii M. The Effects of Vitamin D on Immune System and Inflammatory Diseases. Biomolecules. 2021; 11(11):1624. https://doi.org/10.3390/biom11111624

Chung C, Silwal P, Kim I, Modlin RL, Jo EK. Vitamin D-Cathelicidin Axis: at the Crossroads between Protective Immunity and Pathological Inflammation during Infection. Immune Netw. 2020 Feb 11;20(2):e12.

Gallo D, Baci D, Kustrimovic N, Lanzo N, Patera B, Tanda ML, Piantanida E, Mortara L. How Does Vitamin D Affect Immune Cells Crosstalk in Autoimmune Diseases? International Journal of Molecular Sciences. 2023; 24(5):4689.

Hsieh E, Yin MT. Continued Interest and Controversy: Vitamin D in HIV. Curr HIV/AIDS Rep. 2018 Jun;15(3):199-211. doi: 10.1007/s11904-018-0401-4. PMID: 29713871; PMCID: PMC6003869.

Alvarez N, Aguilar-Jimenez W, Rugeles MT. The Potential Protective Role of Vitamin D Supplementation on HIV-1 Infection. Front Immunol. 2019 Sep 25;10:2291. doi: 10.3389/fimmu.2019.02291. PMID: 31611877; PMCID: PMC6773828.

Dominguez LJ, Farruggia M, Veronese N, Barbagallo M. Vitamin D Sources, Metabolism, and Deficiency: Available Compounds and Guidelines for Its Treatment. Metabolites. 2021; 11(4):255. https://doi.org/10.3390/metabo11040255

Almeida-Afonso R, Finamor D, Fonseca LAM, Veiga APR, Monteiro MA, et al. Efficacy of vitamin D supplementation among persons living with HIV/AIDS in São Paulo city, Brazil. Braz J Infect Dis. 2021 May-Jun;25(3):101598. doi: 10.1016/j.bjid.2021.101598. Epub 2021 Jul 16. PMID: 34280356; PMCID: PMC9392205.

Teixeira NDSCCA, Pereira BM, Oliveira IKF, Lima CHR, Carvalho CMRG, Nunes IFOC, Costa DL, Paiva AA. Effect of vitamin D3 supplementation on HIV-infected adults: a systematic reviewVitamin Dӡ Supplementation on HIV-Infected Adults: A Systematic Review. Nutr Hosp. 2019 Oct 17;36(5):1205-1212. English. doi: 10.20960/nh.02647. PMID: 31526009.

Permata, M., Harun Hudari, Mediarty, & Taufik Indrajaya. The Effect of Vitamin D Supplementation on the Increase in CD4 count of HIV/AIDS Patients Receiving Antiretroviral Therapy. Bioscientia Medicina : Journal of Biomedicine and Translational Research. 2020; 5(1): 144-147. https://doi.org/10.32539/bsm.v5i1.186

Ashenafi S, Amogne W, Kassa E, Gebreselassie N, Bekele A, Aseffa G, Getachew M, Aseffa A, Worku A, Hammar U, Bergman P, Aderaye G, Andersson J, Brighenti S. Daily Nutritional Supplementation with Vitamin D₃ and Phenylbutyrate to Treatment-Naïve HIV Patients Tested in a Randomized Placebo-Controlled Trial. Nutrients. 2019 Jan 10;11(1):133. doi: 10.3390/nu11010133. PMID: 30634590; PMCID: PMC6356462.

Manion, M.; Hullsiek, K.H.; Wilson, E.M.P.; Rhame, F.; Kojic, E.; Gibson, D.; Hammer, J.; Patel, P.; Brooks, J.T.; Baker, J.V.; et al. Vitamin D deficiency is associated with IL-6 levels and monocyte activation in HIV-infected persons. PLoS ONE 2017, 12, e0175517.

Jimenez-Sousa, M.A.; Martinez, I.; Medrano, L.M.; Fernandez-Rodriguez, A.; Resino, S. Vitamin D in Human Immunodeficiency Virus Infection: Influence on Immunity and Disease. Front. Immunol. 2018, 9, 458.

Rockwell M, Kraak V, Hulver M, Epling J. Clinical Management of Low Vitamin D: A Scoping Review of Physicians' Practices. Nutrients. 2018 Apr 16;10(4):493. doi: 10.3390/nu10040493. PMID: 29659534; PMCID: PMC5946278.

Submitted

2024-03-15
Accepted
2024-05-28
Published
2024-08-30

Most read articles by the same author(s)