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Human immunodeficiency virus (HIV) causes acquired immunodeficiency syndrome (AIDS). The immune system begins to fail. This leads to life-threatening infections.

Approximately 33 million people in the world are living with HIV or AIDS. The rates are highest in Africa. About 120,000 have HIV/AIDS in the United States. Each year, approximately 22,000 die.

Risk factors

The primary risk factor for HIV/AIDS is exposure to HIV. This usually occurs with unprotected sexual contact or needle exchange during drug use.

Sunlight exposure and HIV/AIDS risk

There is little reported research on the role of sunlight and HIV. A study in Baltimore, Maryland, found that purposely seeking sun exposure lowered the rate of AIDS progression by 33%. However, the result was not considered statistically significant. The reduction may have occurred by chance.

Vitamin D and HIV/AIDS

Vitamin D levels

In Tanzania, pregnant women with HIV were studied for about five years. Findings included:

  • Higher vitamin D levels were associated with a slower progression of HIV to AIDS.
  • Women with vitamin D levels above 32 ng/mL (80 nmol/L) had a 25% lower risk of disease progression.
  • Women with higher vitamin D levels had a lower risk of dying from any cause during the study.

How vitamin D works

Vitamin D benefits patients with HIV or AIDS because it:

  • Reduces the risk of bone mineral loss and osteoporosis
  • Improves the immune system by producing cathelicidin and defensins (proteins that help fight bacteria and viruses)
  • Reduces inflammation by shifting protein production away from inflammation
  • Improves muscle strength
  • Improves blood sugar control and reduces the risk of diabetes


There have been no reported studies using vitamin D to prevent HIV and its progression to AIDS. However, higher vitamin D levels may reduce HIV risk and progression.

From studies on other diseases, it appears that vitamin D levels above 40 ng/mL (100 nmol/L) may be desirable.

Vitamin D and calcium

There is no evidence that calcium reduces the risk of HIV/AIDS. However, people with these disorders often have lower bone mineral density and increased risk of osteoporosis.

Raising vitamin D levels and taking other supplements may lower osteoporosis risk. These supplements include calcium, magnesium, boron, vitamin C, and hydrolyzed collagen.


People with HIV/AIDS would benefit by measuring their vitamin D blood levels. Supplements could raise vitamin D levels to at least 40 ng/mL (100 nmol/L). However, there is considerable variation from person to person. Vitamin D levels should be measured both before and after taking vitamin D supplements or increasing ultraviolet-B (UVB)


This evidence summary was written by:

William B. Grant, Ph.D.
Sunlight, Nutrition, and Health Research Center (SUNARC)
P.O. Box 641603
San Francisco, CA 94164-1603, USA
[email protected]

The summary was reviewed by:

  • Luca Mascitelli
  • Robert P. Heaney

Complete bibliography of research used in this summary

The research we have cited in our summary is listed below, with links to PubMed abstracts and full-text for those who wish to explore further.


  1. Alagarasu, K. Selvaraj, P. Swaminathan, S. Narendran, G. Narayanan, P. R. 5′ regulatory and 3′ untranslated region polymorphisms of vitamin D receptor gene in south Indian HIV and HIV-TB patients. J Clin Immunol. 2009 Mar; 29 (2): 196-204.
  2. Annapoorna, N. Rao, G. V. Reddy, N. S. Rambabu, P. Rao, K. R. An Increased Risk of Osteoporosis during Acquired Immunodeficiency Syndrome. Int J Med Sci. 2004; 1 (3): 152-164.
  3. Arpadi, S. M. McMahon, D. Abrams, E. J. Bamji, M. Purswani, M. Engelson, E. S. Horlick, M. Shane, E. Effect of bimonthly supplementation with oral cholecalciferol on serum 25-hydroxyvitamin D concentrations in HIV-infected children and adolescents. Pediatrics. 2009 Jan; 123 (1): e121-6.
  4. Bang, U. C. Shakar, S. A. Hitz, M. F. Jespersen, M. S. Andersen, O. Nielsen, S. D. Jensen, J. E. Deficiency of 25-hydroxyvitamin D in male HIV-positive patients: a descriptive cross-sectional study. Scand J Infect Dis. 2010 Apr; 42 (4): 306-10.
  5. Bergman, P. Walter-Jallow, L. Broliden, K. Agerberth, B. Soderlund, J. The antimicrobial peptide LL-37 inhibits HIV-1 replication. Curr HIV Res. 2007 Jul; 5 (4): 410-5.
  6. Biswas, P. Mengozzi, M. Mantelli, B. Delfanti, F. Brambilla, A. Vicenzi, E. Poli, G. 1,25-Dihydroxyvitamin D3 upregulates functional CXCR4 human immunodeficiency virus type 1 coreceptors in U937 minus clones: NF-kappaB-independent enhancement of viral replication. J Virol. 1998 Oct; 72 (10): 8380-3.
  7. Brot, C. Jorgensen, N. R. Sorensen, O. H. The influence of smoking on vitamin D status and calcium metabolism. Eur J Clin Nutr. 1999 Dec; 53 (12): 920-6.
  8. Brown, T. T. McComsey, G. A. Association between initiation of antiretroviral therapy with efavirenz and decreases in 25-hydroxyvitamin D. Antivir Ther. 2010; 15 (3): 425-9.
  9. Cantorna, M. T. Mahon, B. D. D-hormone and the immune system. J Rheumatol Suppl. 2005 Sep; 7611-20.
  10. Childs, K. E. Fishman, S. L. Constable, C. Gutierrez, J. A. Wyatt, C. M. Dieterich, D. T. Mullen, M. P. Branch, A. D. Short communication: Inadequate vitamin D exacerbates parathyroid hormone elevations in tenofovir users. AIDS Res Hum Retroviruses. 2010 Aug; 26 (8): 855-9.
  11. Chinen, J. Shearer, W. T. Secondary immunodeficiencies, including HIV infection. J Allergy Clin Immunol. 2010 Feb; 125 (2 Suppl 2): S195-203.
  12. Conesa-Botella, A. Mathieu, C. Colebunders, R. Moreno-Reyes, R. van Etten, E. Lynen, L. Kestens, L. Is vitamin D deficiency involved in the immune reconstitution inflammatory syndrome?. AIDS Res Ther. 2009; 64.
  13. Connor, R. I. Rigby, W. F. 1 alpha,25-dihydroxyvitamin D3 inhibits productive infection of human monocytes by HIV-1. Biochem Biophys Res Commun. 1991 Apr 30; 176 (2): 852-9.
  14. Conrado, T. Miranda-Filho Dde, B. Bandeira, F. Vitamin D deficiency in HIV-infected individuals: one more risk factor for bone loss and cardiovascular disease?. Arq Bras Endocrinol Metabol. 2010 Mar; 54 (2): 118-22.
  15. Cozzolino, M. Vidal, M. Arcidiacono, M. V. Tebas, P. Yarasheski, K. E. Dusso, A. S. HIV-protease inhibitors impair vitamin D bioactivation to 1,25-dihydroxyvitamin D. AIDS. 2003 Mar 7; 17 (4): 513-20.
  16. de la Torre, M. S. Torres, C. Nieto, G. Vergara, S. Carrero, A. J. Macias, J. Pineda, J. A. Caruz, A. Fibla, J. Vitamin D receptor gene haplotypes and susceptibility to HIV-1 infection in injection drug users. J Infect Dis. 2008 Feb 1; 197 (3): 405-10.
  17. Eisenhut, M. Effect of vitamin D on tuberculosis and HIV replication depends on conversion to calcitriol and concentration. Am J Respir Crit Care Med. 2009 Oct 15; 180 (8): 795; author reply 795-6.
  18. EuroHIV HIV/AIDS Surveillance in Europe: Mid-year report 2007. 2007;
  19. Fibla, J. Caruz, A. Vitamin D and HIV Infection. Soluble Factors Dediating Immune Response to HIV Infection. 2010;
  20. Fox, J. Peters, B. Prakash, M. Arribas, J. Hill, A. Moecklinghoff, C. Improvement in Vitamin D Deficiency Following Antiretroviral Regime Change: Results from the MONET Trial. AIDS Res Hum Retroviruses. 2010 Sep 21;
  21. Gombart, A. F. The vitamin D-antimicrobial peptide pathway and its role in protection against infection. Future Microbiol. 2009 Nov; 41151-65.
  22. Gyllensten, K. Josephson, F. Lidman, K. Saaf, M. Severe vitamin D deficiency diagnosed after introduction of antiretroviral therapy including efavirenz in a patient living at latitude 59 degrees N. AIDS. 2006 Sep 11; 20 (14): 1906-7.
  23. Hathcock, J. N. Shao, A. Vieth, R. Heaney, R. Risk assessment for vitamin D. Am J Clin Nutr. 2007 Jan; 85 (1): 6-18.
  24. Haug, C. Muller, F. Aukrust, P. Froland, S. S. Subnormal serum concentration of 1,25-vitamin D in human immunodeficiency virus infection: correlation with degree of immune deficiency and survival. J Infect Dis. 1994 Apr; 169 (4): 889-93.
  25. Haug, C. J. Aukrust, P. Haug, E. Morkrid, L. Muller, F. Froland, S. S. Severe deficiency of 1,25-dihydroxyvitamin D3 in human immunodeficiency virus infection: association with immunological hyperactivity and only minor changes in calcium homeostasis. J Clin Endocrinol Metab. 1998 Nov; 83 (11): 3832-8.
  26. Haug, C. J. Muller, F. Aukrust, P. Froland, S. S. Different effect of 1,25-dihydroxyvitamin D3 on replication of Mycobacterium avium in monocyte-derived macrophages from human immunodeficiency virus-infected subjects and healthy controls. Immunol Lett. 1998 Sep; 63 (2): 107-12.
  27. Holick, M. F. Vitamin D deficiency. N Engl J Med. 2007 Jul 19; 357 (3): 266-81.
  28. Joshi, R. Hypercalcemia due to hypervitaminosis D: report of seven patients. J Trop Pediatr. 2009 Dec; 55 (6): 396-8.
  29. Kipp, D. E. McElvain, M. Kimmel, D. B. Akhter, M. P. Robinson, R. G. Lukert, B. P. Scurvy results in decreased collagen synthesis and bone density in the guinea pig animal model. Bone. 1996 Mar; 18 (3): 281-8.
  30. Kizaki, M. Ikeda, Y. Simon, K. J. Nanjo, M. Koeffler, H. P. Effect of 1,25-dihydroxyvitamin D3 and its analogs on human immunodeficiency virus infection in monocytes/macrophages. Leukemia. 1993 Oct; 7 (10): 1525-30.
  31. Kuehn, E. W. Anders, H. J. Bogner, J. R. Obermaier, J. Goebel, F. D. Schlondorff, D. Hypocalcaemia in HIV infection and AIDS. J Intern Med. 1999 Jan; 245 (1): 69-73.
  32. Lau, B. Gange, S. J. Phair, J. P. Riddler, S. A. Detels, R. Margolick, J. B. Rapid declines in total lymphocyte counts and hemoglobin concentration prior to AIDS among HIV-1-infected men. AIDS. 2003 Sep 26; 17 (14): 2035-44.
  33. Lavae-Mokhtari, M. Mohammad-Khani, S. Schmidt, R. E. Stoll, M. [Acute renal failure and hypercalcemia in an AIDS patient on tenofovir and low-dose vitamin D therapy with immune reconstitution inflammatory syndrome]. Med Klin (Munich). 2009 Oct 15; 104 (10): 810-3.
  34. Maas, J. Termorshuizen, F. Geskus, R. B. Goettsch, W. Coutinho, R. A. Miedema, F. Van Loveren, H. Amsterdam Cohort Study on HIV and AIDS: impact of exposure to UVR as estimated by means of a 2-year retrospective questionnaire on immune parameters in HIV positive males. Int J Hyg Environ Health. 2002 Jul; 205 (5): 373-7.
  35. Madeddu, G. Spanu, A. Solinas, P. Calia, G. M. Lovigu, C. Chessa, F. Mannazzu, M. Falchi, A. Mura, M. S. Bone mass loss and vitamin D metabolism impairment in HIV patients receiving highly active antiretroviral therapy. Q J Nucl Med Mol Imaging. 2004 Mar; 48 (1): 39-48.
  36. McComsey, G. A. Kendall, M. A. Tebas, P. Swindells, S. Hogg, E. Alston-Smith, B. Suckow, C. Gopalakrishnan, G. Benson, C. Wohl, D. A. Alendronate with calcium and vitamin D supplementation is safe and effective for the treatment of decreased bone mineral density in HIV. AIDS. 2007 Nov 30; 21 (18): 2473-82.
  37. Mehta, S. Giovannucci, E. Mugusi, F. M. Spiegelman, D. Aboud, S. Hertzmark, E. Msamanga, G. I. Hunter, D. Fawzi, W. W. Vitamin D status of HIV-infected women and its association with HIV disease progression, anemia, and mortality. PLoS One. 2010; 5 (1): e8770.
  38. Mehta, S. Hunter, D. J. Mugusi, F. M. Spiegelman, D. Manji, K. P. Giovannucci, E. L. Hertzmark, E. Msamanga, G. I. Fawzi, W. W. Perinatal outcomes, including mother-to-child transmission of HIV, and child mortality and their association with maternal vitamin D status in Tanzania. J Infect Dis. 2009 Oct 1; 200 (7): 1022-30.
  39. Mondy, K. Powderly, W. G. Claxton, S. A. Yarasheski, K. H. Royal, M. Stoneman, J. S. Hoffmann, M. E. Tebas, P. Alendronate, vitamin D, and calcium for the treatment of osteopenia/osteoporosis associated with HIV infection. J Acquir Immune Defic Syndr. 2005 Apr 1; 38 (4): 426-31.
  40. Mueller, N. J. Fux, C. A. Ledergerber, B. Elzi, L. Schmid, P. Dang, T. Magenta, L. Calmy, A. Vergopoulos, A. Bischoff-Ferrari, H. A. High prevalence of severe vitamin D deficiency in combined antiretroviral therapy-naive and successfully treated Swiss HIV patients. AIDS. 2010 May 15; 24 (8): 1127-34.
  41. Mulligan, G. B. Licata, A. Taking vitamin D with the largest meal improves absorption and results in higher serum levels of 25-hydroxyvitamin D. J Bone Miner Res. 2010 Apr; 25 (4): 928-30.
  42. Nevado, J. Tenbaum, S. P. Castillo, A. I. Sanchez-Pacheco, A. Aranda, A. Activation of the human immunodeficiency virus type I long terminal repeat by 1 alpha,25-dihydroxyvitamin D3. J Mol Endocrinol. 2007 Jun; 38 (6): 587-601.
  43. Nieto, G. Barber, Y. Rubio, M. C. Rubio, M. Fibla, J. Association between AIDS disease progression rates and the Fok-I polymorphism of the VDR gene in a cohort of HIV-1 seropositive patients. J Steroid Biochem Mol Biol. 2004 May; 89-90 (1-5): 199-207.
  44. Paul, T. V. Asha, H. S. Thomas, N. Seshadri, M. S. Rupali, P. Abraham, O. C. Pulimood, S. A. Jose, A. Hypovitaminosis D and bone mineral density in human immunodeficiency virus-infected men from India, with or without antiretroviral therapy. Endocr Pract. 2010 Jul-Aug; 16 (4): 547-53.
  45. Pauza, C. D. Kornbluth, R. Emau, P. Richman, D. D. Deftos, L. J. Vitamin D3 compounds regulate human immunodeficiency virus type 1 replication in U937 monoblastoid cells and in monocyte-derived macrophages. J Leukoc Biol. 1993 Feb; 53 (2): 157-64.
  46. Ramayo, E. Gonzalez-Moreno, M. P. Macias, J. Cruz-Ruiz, M. Mira, J. A. Villar-Rueda, A. M. Garcia-Garcia, J. A. Gomez-Mateos, J. M. Lozano, F. Pineda, J. A. Relationship between osteopenia, free testosterone, and vitamin D metabolite levels in HIV-infected patients with and without highly active antiretroviral therapy. AIDS Res Hum Retroviruses. 2005 Nov; 21 (11): 915-21.
  47. Rejnmark, L. Vestergaard, P. Heickendorff, L. Mosekilde, L. Plasma 1,25(OH)2D levels decrease in postmenopausal women with hypovitaminosis D. Eur J Endocrinol. 2008 Apr; 158 (4): 571-6.
  48. Rodriguez, M. Daniels, B. Gunawardene, S. Robbins, G. K. High frequency of vitamin D deficiency in ambulatory HIV-Positive patients. AIDS Res Hum Retroviruses. 2009 Jan; 25 (1): 9-14.
  49. Rosenvinge, M. M. Gedela, K. Copas, A. J. Wilkinson, A. Sheehy, C. A. Bano, G. Hay, P. E. Pakianathan, M. R. Sadiq, S. T. Tenofovir-linked hyperparathyroidism is independently associated with the presence of vitamin D deficiency. J Acquir Immune Defic Syndr. Aug 15; 54 (5): 496-9.
  50. Saah, A. J. Horn, T. D. Hoover, D. R. Chen, C. Whitmore, S. E. Flynn, C. Wesch, J. Detels, R. Anderson, R. Solar ultraviolet radiation exposure does not appear to exacerbate HIV infection in homosexual men. The Multicenter AIDS Cohort Study. AIDS. 1997 Nov 15; 11 (14): 1773-8.
  51. Stein, E. M. Yin, M. T. McMahon, D. J. Shu, A. Zhang, C. A. Ferris, D. C. Colon, I. Dobkin, J. F. Hammer, S. M. Shane, E. Vitamin D deficiency in HIV-infected postmenopausal Hispanic and African-American women. Osteoporos Int. 2010 Jun 29;
  52. Stephensen, C. B. Marquis, G. S. Kruzich, L. A. Douglas, S. D. Aldrovandi, G. M. Wilson, C. M. Vitamin D status in adolescents and young adults with HIV infection. Am J Clin Nutr. 2006 May; 83 (5): 1135-41.
  53. Termorshuizen, F. Geskus, R. B. Roos, M. T. Coutinho, R. A. Van Loveren, H. Seasonal influences on immunological parameters in HIV-infected homosexual men: searching for the immunomodulating effects of sunlight. Int J Hyg Environ Health. 2002 Jul; 205 (5): 379-84.
  54. Torres, C. de la Torre, M. S. Garcia-Moruja, C. Carrero, A. J. Del Monte, M. T. Fibla, J. Caruz, A. Immunophenotype of Vitamin D Receptor Polymorphism Associated to Risk of HIV-1 Infection and Rate of Disease Progression. Curr HIV Res. 2010 Sep 1; 8 (6): 487-92.
  55. Tuon, F. F. Nihei, C. H. Gryschek, R. C. Seguro, A. C. Vitamin D intoxication: a cause of hypocalcaemia and acute renal failure in a HIV patient. Int J STD AIDS. 2008 Feb; 19 (2): 137-8.
  56. van den Bout-van den Beukel, C. J. Fievez, L. Michels, M. Sweep, F. C. Hermus, A. R. Bosch, M. E. Burger, D. M. Bravenboer, B. Koopmans, P. P. Van Der Ven, A. J. Vitamin D deficiency among HIV type 1-infected individuals in the Netherlands: effects of antiretroviral therapy. AIDS Res Hum Retroviruses. 2008 Nov; 24 (11): 1375-82.
  57. van den Bout-van den Beukel, C. J. van den Bos, M. Oyen, W. J. Hermus, A. R. Sweep, F. C. Tack, C. J. Bosch, M. E. Burger, D. M. Koopmans, P. P. van der Ven, A. J. The effect of cholecalciferol supplementation on vitamin D levels and insulin sensitivity is dose related in vitamin D-deficient HIV-1-infected patients. HIV Med. 2008 Oct; 9 (9): 771-9.
  58. Vetter, M. L. Johnson, M. E. Antons, A. K. Unutmaz, D. D’Aquila, R. T. Differences in APOBEC3G expression in CD4+ T helper lymphocyte subtypes modulate HIV-1 infectivity. PLoS Pathog. 2009 Feb; 5 (2): e1000292.
  59. Villamor, E. A potential role for vitamin D on HIV infection?. Nutr Rev. 2006 May; 64 (5 Pt 1): 226-33.
  60. Wang, T. J. Zhang, F. Richards, J. B. Kestenbaum, B. van Meurs, J. B. Berry, D. Kiel, D. P. Streeten, E. A. Ohlsson, C. Koller, D. L. Peltonen, L. Cooper, J. D. O’Reilly, P. F. Houston, D. K. Glazer, N. L. Vandenput, L. Peacock, M. Shi, J. Rivadeneira, F. McCarthy, M. I. Anneli, P. de Boer, I. H. Mangino, M. Kato, B. Smyth, D. J. Booth, S. L. Jacques, P. F. Burke, G. L. Goodarzi, M. Cheung, C. L. Wolf, M. Rice, K. Goltzman, D. Hidiroglou, N. Ladouceur, M. Wareham, N. J. Hocking, L. J. Hart, D. Arden, N. K. Cooper, C. Malik, S. Fraser, W. D. Hartikainen, A. L. Zhai, G. Macdonald, H. M. Forouhi, N. G. Loos, R. J. Reid, D. M. Hakim, A. Dennison, E. Liu, Y. Power, C. Stevens, H. E. Jaana, L. Vasan, R. S. Soranzo, N. Bojunga, J. Psaty, B. M. Lorentzon, M. Foroud, T. Harris, T. B. Hofman, A. Jansson, J. O. Cauley, J. A. Uitterlinden, A. G. Gibson, Q. Jarvelin, M. R. Karasik, D. Siscovick, D. S. Econs, M. J. Kritchevsky, S. B. Florez, J. C. Todd, J. A. Dupuis, J. Hypponen, E. Spector, T. D. Common genetic determinants of vitamin D insufficiency: a genome-wide association study. Lancet. 2010 Jul 17; 376 (9736): 180-8.
  61. Wasserman, P. Rubin, D. S. Highly prevalent vitamin D deficiency and insufficiency in an urban cohort of HIV-infected men under care. AIDS Patient Care STDS. 2010 Apr; 24 (4): 223-7.
  62. Welz, T. Childs, K. Ibrahim, F. Poulton, M. Taylor, C. B. Moniz, C. F. Post, F. A. Efavirenz is associated with severe vitamin D deficiency and increased alkaline phosphatase. AIDS. 2010 Jul 31; 24 (12): 1923-8.
  63. White, J. H. Vitamin D as an inducer of cathelicidin antimicrobial peptide expression: past, present and future. J Steroid Biochem Mol Biol. 2010 Jul; 121 (1-2): 234-8.
  64. Woolley, I. J. Giles, M. L. Howard, J. E. Korman, T. M. Unrecognised vitamin D deficiency: low concentrations in African migrants with HIV in Australia. Sex Health. 2008 Dec; 5 (4): 375-6.
  65. Yamashita, T. Nomaguchi, M. Miyake, A. Uchiyama, T. Adachi, A. Status of APOBEC3G/F in cells and progeny virions modulated by Vif determines HIV-1 infectivity. Microbes Infect. 2010 Feb; 12 (2): 166-71.
  66. Yin, M. T. Lu, D. Cremers, S. Tien, P. C. Cohen, M. H. Shi, Q. Shane, E. Golub, E. T. Anastos, K. Short-term bone loss in HIV-infected premenopausal women. J Acquir Immune Defic Syndr. 2010 Feb 1; 53 (2): 202-8.

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