Decrease of vitamin D concentration in patients with HIV infection on a non nucleoside reverse transcriptase inhibitor-containing regimen

<p>Abstract</p> <p>Background</p> <p>Vitamin D is an important determinant of bone health and also plays a major role in the regulation of the immune system. Interestingly, vitamin D status before the start of highly active antiretroviral therapy (HAART) has been recently associated with HIV disease progression and overall mortality in HIV-positive pregnant women. We prospectively studied vitamin D status in HIV individuals on HAART in Belgium.</p> <p>We selected samples from HIV-positive adults starting HAART with a pre-HAART CD4 T-cell count >100 cells/mm³followed up for at least 12 months without a treatment change. We compared 25-hydroxyvitamin D plasma [25-(OH)D] concentration in paired samples before and after 12 months of HAART. 25-(OH)D levels are presented using two different cut-offs: <20 ng/ml and <30 ng/ml.</p> <p>Results</p> <p>Vitamin D deficiency was common before HAART, the frequency of plasma 25-(OH)D concentrations below 20 ng/ml and 30 below ng/ml was 43.7% and 70.1% respectively. After 12 months on HAART, the frequency increased to 47.1% and 81.6%.</p> <p>HAART for 12 months was associated with a significant decrease of plasma 25-(OH)D concentration (p = 0.001). Decreasing plasma 25-(OH)D concentration on HAART was associated in the multivariate model with NNRTI-based regimen (p = 0.001) and lower body weight (p = 0.008). Plasma 25-(OH)D concentrations decreased significantly in both nevirapine and efavirenz-containing regimens but not in PI-treated patients.</p> <p>Conclusions</p> <p>Vitamin D deficiency is frequent in HIV-positive individuals and NNRTI therapy further decreases 25-(OH)D concentrations. Consequently, vitamin D status need to be checked regularly in all HIV-infected patients and vitamin D supplementation should be given when needed.</p

Is vitamin D deficiency involved in the immune reconstitution inflammatory syndrome?

<p>Abstract</p> <p>Background</p> <p>About 20–30% of persons with HIV infection, especially those living in countries with limited resources, experience an immune reconstitution inflammatory syndrome (IRIS) after starting antiretroviral treatment. The active form of vitamin D, 1,25-dihydroxyvitamin D, is a key player in the clearance of pathogens and influences the level of inflammation and macrophage activation.</p> <p>Presentation of the hypothesis</p> <p>We hypothesize that low availability of 1,25-dihydroxyvitamin D, either due to vitamin D deficiency or due to polymorphisms in the vitamin D receptor or in its activating/inactivating enzymes, contributes to the appearance of IRIS. Furthermore, drug interactions with the enzymatic pathways of vitamin D could favour the development of IRIS.</p> <p>Testing the hypothesis</p> <p>Our hypothesis could be explored by a case-control study to assess the prevalence of vitamin D deficiency in HIV-infected patients on antiretroviral treatment who develop and do not develop IRIS.</p> <p>Implications of the hypothesis</p> <p>If the role of vitamin D in IRIS is confirmed, we would be able to screen patients at risk for IRIS by screening for vitamin D deficiency. After confirmation by means of a clinical trial, vitamin D supplementation could be a cheap and safe way to reduce the incidence of IRIS.</p

Tuberculosis in human immunodeficiency virus infected Ugandan children starting on antiretroviral therapy

This article argues that in the first verse of Catullus’ epigram 85, the commonly found translation of quare as ‘why’ in English versions since the 17th century, but particularly in translations produced in the last fifty years, cannot be accepted. In the context of Catullus’s poetry, with poems 72 and 75 offering an explicit background to and rationale for the contradiction in the poet’s feelings between love and hate, and in the light of the incontrovertible connotation of quare (or qua re) as ‘how’ in a passage of Terence’s Eunuchus, the correct translation of the word can only be ‘how’. Some suggestions are made to account for the origins and the persistence of the mistranslation. The translation as ‘why’ in the prose version in the 1912 Loeb edition edited by F.W.Cornish is suggested to have influenced a generation of English-speaking students, and Martial’s epigram 1.32 is invoked as a cause. But it is further argued that in taking Catullus’s epigram as a model for his own, Martial may have expressly intended to suggest that the meaning of quare as ‘why’ that was current in his time was different in that very respect from the connotation ‘how’ clearly intended by his predecessor