Vitamin D status of HIV-infected women and its association with HIV disease progression, anemia, and mortality.
Vitamin D status of HIV-infected women and its association with HIV disease progression, anemia, and mortality.
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DOI：
10.1371/journal.pone.0008770
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发表时间：
2010-01-19
期刊：
影响因子：
3.7
通讯作者：
Fawzi WW
中科院分区：
文献类型：
--
作者：
Mehta S;Giovannucci E;Mugusi FM;Spiegelman D;Aboud S;Hertzmark E;Msamanga GI;Hunter D;Fawzi WW
维生素D在减缓艾滋病毒疾病进展和预防死亡方面具有潜在作用，因为它广泛参与免疫系统;然而，这种关系尚未在大型研究或资源有限的环境中进行研究。在坦桑尼亚的一项补充多种维生素（不包括维生素D）的试验中，对884名感染艾滋病毒的孕妇进行了维生素D水平评估。女性随访时间中位数为69.5个月，并记录血红蛋白水平，HIV疾病进展和死亡率的信息。比例风险模型和广义估计方程被用来评估这些结果与维生素D状态的关系。在多变量模型中，低维生素D状态（血清25-羟基维生素D<32 ng/mL）与进展至WHO HIV疾病III期或更高阶段显著相关（发病率比[RR]：1.25; 95%置信区间[CI]：1.05，1.50）。在随访期间，维生素D状态和T细胞计数之间没有显著关系。与维生素D水平充足的女性相比，维生素D水平低的女性在随访期间发生严重贫血的风险高46%（RR：1.46; 95% CI：1.09，1.96）。维生素D含量最高的五分之一女性的全因死亡风险比最低的五分之一女性低42%（RR：0.58; 95% CI：0.40，0.84）。维生素D状态与HIV感染妇女的HIV疾病进展、全因死亡率和随访期间贫血的发生有保护性关系。如果在随机试验中得到证实，补充维生素D可能是延长艾滋病毒感染患者开始抗逆转录病毒治疗时间的一种简单而廉价的方法，特别是在资源有限的情况下。
Vitamin D has a potential role in slowing HIV disease progression and preventing mortality based on its extensive involvement in the immune system; however, this relationship has not been examined in large studies or in resource-limited settings. Vitamin D levels were assessed in 884 HIV-infected pregnant women at enrollment in a trial of multivitamin supplementation (not including vitamin D) in Tanzania. Women were followed up for a median of 69.5 months, and information on hemoglobin levels, HIV disease progression, and mortality was recorded. Proportional hazard models and generalized estimating equations were used to assess the relationship of these outcomes with vitamin D status. Low vitamin D status (serum 25-hydroxyvitamin D<32ng/mL) was significantly associated with progression to WHO HIV disease stage III or greater in multivariate models (incidence rate ratio [RR]: 1.25; 95% confidence intervals [CI]: 1.05, 1.50). No significant relationship was observed between vitamin D status and T-cell counts during follow-up. Women with low vitamin D status had 46% higher risk of developing severe anemia during follow-up, compared to women with adequate vitamin D levels (RR: 1.46; 95% CI: 1.09, 1.96). Women in the highest vitamin D quintile had a 42% lower risk of all-cause mortality, compared to the lowest quintile (RR: 0.58; 95% CI: 0.40, 0.84). Vitamin D status had a protective association with HIV disease progression, all-cause mortality, and development of anemia during follow-up in HIV-infected women. If confirmed in randomized trials, vitamin D supplementation could represent a simple and inexpensive method to prolonging the time to initiation of antiretroviral therapy in HIV-infected patients, particularly in resource-limited settings.
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影响因子：
2
作者：
DURRLEMAN, S;SIMON, R
通讯作者：
SIMON, R
影响因子：
2
作者：
Govindarajulu, Usha S.;Spiegelman, Donna;Eisen, Ellen A.
通讯作者：
Eisen, Ellen A.
影响因子：
56.9
作者：
Liu, PT;Stenger, S;Modlin, RL
通讯作者：
Modlin, RL
DOI：
10.1016/0928-0197(94)90030-2
发表时间：
1994-02-01
期刊：
Clinical and diagnostic virology
影响因子：
--
作者：
Urassa, W;Matunda, S;Biberfeld, G
通讯作者：
Biberfeld, G
影响因子：
4.4
作者：
Liu, Philip T.;Stenger, Steffen;Modlin, Robert L.
通讯作者：
Modlin, Robert L.