Relationship of vitamin D insufficiency to AIDS-associated Kaposi's sarcoma outcomes: retrospective analysis of a prospective clinical trial in Zimbabwe

Int J Infect Dis. 2014 Jul:24:6-10. doi: 10.1016/j.ijid.2014.02.006. Epub 2014 Apr 21.

Abstract

Objectives: The prevalence of vitamin D insufficiency in Africans with AIDS-associated Kaposi sarcoma (AIDS-KS) and the role of vitamin D in AIDS-KS progression are unknown. We hypothesized that a high prevalence of vitamin D deficiency would be found in Zimbabweans with AIDS-KS and that low baseline vitamin D would correlate with progression of AIDS-KS.

Methods: Ninety subjects were enrolled in a prospective pilot study investigation of the effect of antiretroviral therapy in the treatment of AIDS-KS in Harare, Zimbabwe. Co-formulated abacavir, lamivudine, and zidovudine was initiated; chemotherapy was provided at the discretion of the provider. Participants were followed for 96 weeks. 25-Hydroxyvitamin D was measured in stored specimens collected at study entry. The relationship between vitamin D and clinical response was described by odds ratio and 95% confidence interval.

Results: Samples were available for 85 participants; 45 (53%) subjects had inadequate (<75 nmol/l) 25-hydroxyvitamin D. HIV-1 RNA was significantly higher among those with insufficient vitamin D (4.7 vs. 4.5 log, p = 0.04). Tumor response, survival, and KS-IRIS were not associated with vitamin D (p ≥ 0.3).

Conclusions: Vitamin D insufficiency was common among Zimbabweans with AIDS-KS but not associated with outcomes after initiation of antiretroviral therapy.

Keywords: AIDS-KS; HIV; Vitamin D insufficiency.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS-Related Opportunistic Infections / drug therapy*
  • AIDS-Related Opportunistic Infections / mortality
  • AIDS-Related Opportunistic Infections / pathology
  • AIDS-Related Opportunistic Infections / virology
  • Adult
  • Anti-HIV Agents / therapeutic use*
  • Dideoxynucleosides / therapeutic use
  • Disease Progression
  • Female
  • HIV-1 / drug effects
  • HIV-1 / growth & development
  • Herpesvirus 8, Human / drug effects
  • Herpesvirus 8, Human / growth & development
  • Humans
  • Lamivudine / therapeutic use
  • Male
  • Middle Aged
  • Odds Ratio
  • Pilot Projects
  • Prospective Studies
  • RNA, Viral / blood*
  • Sarcoma, Kaposi / drug therapy*
  • Sarcoma, Kaposi / mortality
  • Sarcoma, Kaposi / pathology
  • Sarcoma, Kaposi / virology
  • Survival Analysis
  • Treatment Outcome
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood
  • Vitamin D Deficiency / drug therapy*
  • Vitamin D Deficiency / mortality
  • Vitamin D Deficiency / pathology
  • Vitamin D Deficiency / virology
  • Zidovudine / therapeutic use
  • Simbabwe

Substances

  • Anti-HIV Agents
  • Dideoxynucleosides
  • RNA, Viral
  • Vitamin D
  • Lamivudine
  • Zidovudine
  • 25-hydroxyvitamin D
  • abacavir

Supplementary concepts

  • AIDS-related Kaposi sarcoma