RCT: Efficacy of vitamin D supplementation varies with age and treatment in patients with HIV

Posted on: March 9, 2015   by  Vitamin D Council

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A recent pilot randomized controlled trial found that age and antiretroviral therapy (ART) regimen modified the response of vitamin D supplementation. The study also confirmed that high dose vitamin D supplementation is safe and improves HIV status among both children and adults.

Researchers have found a high prevalence of vitamin D deficiency among HIV patients. Some studies have suggested that HIV patients with low vitamin D levels are at an increased risk of mortality.

A previous randomized controlled trial found that vitamin D supplementation improved immune markers among patients undergoing highly active ART, a regimen given to HIV patients in order to slow the progression of the disease.

In the current study, researchers wanted to determine the safety and efficacy of high dose vitamin D supplementation. They also wanted to know whether any variable significantly modified the effectiveness of vitamin D supplementation in HIV patients.

A total of 60 participants from Batswana were randomly divided into two groups in which one received 4,000 IU daily and the other received 7,000 IU daily for 12 weeks.

After 12 weeks, 90% of all participants achieved a vitamin D level above 32 ng/ml. The change invitamin D levels was similar between the two groups. Only three participants had high calcium levels but they did not require clinical interventions.

The researchers found that younger children and older adults experienced a greater change in vitamin D levels than adolescents and young adults (p < 0.001). Additionally, the type of ART modified the effectiveness of supplementation: the change in vitamin D levels was significantly greater in those taking nevirapine or efavirenz compared to those taking protease inhibitor based treatments (p < 0.044).

Nevirapine and efavirenz are categorized as reverse transcriptase inhibitors (RTIs). RTIs are a class of antiviral drugs which work by inhibiting an enzyme needed for the replication of HIV. Protease inhibitors are also a class of antiviral drugs that prevent replication of HIV by binding to the enzyme needed for the production of infectious viral particles.

Children and adolescents receiving 7,000 IU daily experienced an improvement in height status after 12 weeks of supplementation.

The researchers also found that vitamin D supplementation significantly reduced the HIV viral load (VL) (p < 0.04). VL refers to the amount of HIV present in your blood. The lower the viral load, the lower the concentrations of HIV in the blood.

The researchers concluded,

“In a pilot study in Botswana, 12-week high dose D₃ supplementation was safe and improved vitamin D, growth and HIV status; age and ART regimen were significant effect modifiers.”

Source

Steenhoff A., et al. Vitamin D₃ Supplementation in Batswana Children and Adults with HIV: A Pilot Double Blind Randomized Controlled Trial. PLOS ONE, 2015.

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