Prevalence and risk factors for low bone mineral density in antiretroviral therapy-naive HIV-infected young men

Objective

We aimed to investigate the prevalence of low bone mineral density (BMD) and associated factors in antiretroviral therapy (ART)-naive HIV-infected young men.

Predictors of mortality among HIV-infected children receiving highly active antiretroviral therapy

Background and objectivesThe mortality rate of HIV-infected children can be reversed under highly active antiretroviral therapy (HAART). The impact of HAART on the mortality of HIV-infected children in Cameroon has not been extensively documented. We aimed to measure the mortality rate of HIV-infected children under HAART and to identify predictive factors of mortality.MethodsRetrospective cohort study of 221 children initiated on HAART from 2005 to 2009 and followed-up until 2013. Survival data was analyzed using Kaplan Meier method and Cox regression model to identify independent predictors of child mortality on HAART.ResultsOverall, 9.9% of children (n = 22) died over a follow-up period of 755 child-years (mortality of 2.9 per 100 child-years); 70% of deaths occurred during the first six months of HAART. The probability of survival after four years of treatment was 88.7% (95% CI = [84.2–93.3]). During the multivariate analysis of baseline variables, we observed that the WHO clinical stages III and IV (HR: 3.55 [1.09–13.6] and HR: 7.7 [3.07–31.2]) and age ≤ 1 year at HAART initiation were independently associated with death (HR: 2.1 [1.01–5.08]). Neither orphanhood, baseline CD4 count or hemoglobin level nor low nutritional status predicted death in this cohort.ConclusionThe mortality of children receiving HAART was low after five years of follow-up and it was strongly associated with WHO stages III and IV and a younger age at treatment initiation.     

Increasing procoagulant activity of circulating microparticles in patients living with HIV

ObjectivesHIV-infected individuals are at higher risk of non-AIDS diseases associated with procoagulant status. Microparticles are elevated in disorders associated with thrombosis (e.g., cardiovascular diseases). We investigated the association between microparticle levels in untreated and treated HIV-infected subjects, and determined the association with immune status, viral replication, and duration of antiretroviral therapy.Patients and methodsWe included 144 HIV-infected subjects, including 123 on antiretroviral therapy (ART) and 21 before treatment initiation. A control group of 40 HIV-negative healthy adults matched for age and sex was used for comparison of microparticle levels. Treated subjects were divided into five groups depending on the period of antiretroviral exposure. Statistically significant differences were determined by Kruskal–Wallis test and Chi² test. The relation between microparticles and other parameters was assessed using Spearman's coefficient of correlation.ResultsMicroparticle levels were significantly higher in treated and untreated HIV-infected subjects than in non-HIV-infected controls (P < 0.001). The microparticle level was similar between the groups on treatment (P = 0.913). No association between the microparticle level and CD4+ count, CD4+/CD8+ ratio, number of HIV-1 RNA copies, or duration of exposure to antiretroviral treatment was observed.ConclusionIncreased levels of microparticles may be due to processes independent of viral replication and CD4+ cell count, and microparticle release might persist even during viral suppression by antiretroviral treatment. Elevated microparticle levels might occur in response to other triggers.     

Survie des patients vivant avec le VIH-1 sous thérapie antirétrovirale au Maroc

Background

The purpose was to study factors associated with the survival of HIV-1 patients receiving antiretroviral therapy in Morocco.

孕妇维生素D需要量和补充量的研究进展

孕期大量钙从母体转移给胎儿,以满足胎儿骨骼发育的需求,孕妇除改变自身的代谢外,需要适当增加钙和维生素D摄入量.目前孕妇维生素D需要量和补充量的问题尚未最后明确和定论.本文主要综述相关的研究进展,以供营养工作者在制定孕妇维生素D需要量和补充量时参考.     

天津市2019-2022年新报告HIV感染者抗病毒治疗前病毒载量基线特征分析

目的 了解天津市新报告HIV感染者抗病毒治疗前病毒载量（VL）基线特征及相关因素。方法 资料来源于中国疾病预防控制信息系统,研究对象为天津市2019-2022年新报告且首次抗病毒治疗前HIV感染者,收集其社会人口学特征、CD4⁺T淋巴细胞（CD4）计数及VL值等基线信息,基线高VL值定义标准为≥100 000拷贝数/ml,分析影响VL水平的相关因素。采用SPSS 24.0软件进行统计学分析。结果 研究对象新报告HIV感染者共1 296例,其中,基线高VL值的HIV感染者占15.89%（206/1 296）。多因素logistic回归分析结果显示,有STD史者（aOR=1.45,95%CI：1.00~2.08）,基线高VL值的可能性较大;相比于基线CD4计数<200个/µl者,基线CD4计数分别为200~350个/μl（aOR=0.40,95%CI：0.27~0.57）、351~500个/μl（aOR=0.32,95%CI：0.20~0.49）和>500个/µl者（aOR=0.30,95%CI：0.18~0.49）的基线高VL值的可能性较小。结论 2019-2022年天津市HIV感染者抗病毒治疗前基线VL值高的比例较低,HIV感染者基线VL值高的相关因素为有STD史和基线CD4计数<200个/µl,艾滋病防控工作应给予重点关注。     

Vitamin D status in autism spectrum disorders and the efficacy of vitamin D supplementation in autistic children

Objectives: Autism spectrum disorder (ASD) is a developmental disorder characterized by pervasive deficits in social interaction, impairment in verbal and non-verbal communication, and stereotyped patterns of interests and activities. Vitamin-D deficiency was previously reported in autistic children. However, the data on the relationship between vitamin D deficiency and the severity of autism are limited.

Methods: We performed a case–controlled cross-sectional analysis conducted on 122 ASD children, to assess their vitamin D status compared to controls and the relationship between vitamin D deficiency and the severity of autism. We also conducted an open trial of vitamin D supplementation in ASD children.

Results: Fifty-seven percent of the patients in the present study had vitamin D deficiency, and 30% had vitamin D insufficiency. The mean 25-OHD levels in patients with severe autism were significantly lower than those in patients with mild/moderate autism. Serum 25-OHD levels had significant negative correlations with Childhood Autism Rating Scale (CARS) scores. Of the ASD group, 106 patients with low-serum 25-OHD levels (<30?ng/ml) participated in the open label trial. They received vitamin D3 (300?IU/kg/day not to exceed 5000 IU/day) for 3 months. Eighty-three subjects completed 3 months of daily vitamin D treatment. Collectively, 80.72% (67/83) of subjects who received vitamin D3 treatment had significantly improved outcome, which was mainly in the sections of the CARS and aberrant behavior checklist subscales that measure behavior, stereotypy, eye contact, and attention span.

Conclusion: Vitamin D is inexpensive, readily available and safe. It may have beneficial effects in ASD subjects, especially when the final serum level is more than 40?ng/ml.

Trial registration number: UMIN-CTR Study Design: trial Number: R000016846.     

Vitamin D levels and influenza vaccine immunogenicity among HIV-infected and HIV-uninfected adults

BackgroundVaccination is the most important preventive strategy against influenza, however post-vaccination antibody responses are often inadequate especially among HIV-infected persons. Vitamin D deficiency has been suggested to adversely influence immune responses and is highly prevalent among HIV-infected adults. Therefore, we evaluated the association between 25-hydroxyvitamin D [25(OH)D] levels and post-influenza vaccination responses.MethodsWe conducted a prospective cohort study evaluating the immunogenicity of monovalent influenza A (H1N1) vaccination among both HIV-infected and HIV-uninfected adults (18–50 years of age) during the 2009–2010 influenza season. Antibody titers were evaluated at baseline, day 28, and 6 months post-vaccination using hemagluttination inhibition assays. Serum 25(OH)D levels were measured at day 28. Univariate and multivariate regression analyses examined the association between 25(OH)D levels [categorized as <20 ng/ml (deficiency) vs. ⩾20 ng/ml] with the primary outcome of seroconversion. Secondary outcomes included seroprotection; a ⩾4-fold increase in titers; and geometric mean titers post-vaccination. Analyses were repeated using 25(OH)D levels as a continuous variable.ResultsA total of 128 adults [64 HIV-infected (median CD4 count 580 cells/mm³) and 64 HIV-uninfected] were included. Seroconversion at day 28 post-vaccination was achieved in fewer HIV-infected participants compared with HIV-uninfected participants (56% vs. 74%, p = 0.03). Vitamin D deficiency was more prevalent among HIV-infected persons vs. HIV-uninfected persons (25% vs. 17%), although not significantly different (p = 0.39). There were no associations found between lower 25(OH)D levels and poorer antibody responses at day 28 or 6 months for any of the study outcomes among either HIV-infected or HIV-uninfected adults.ConclusionVitamin D deficiency was common among both HIV-infected and HIV-uninfected adults, but lower levels did not predict antibody responses after H1N1 (2009) influenza vaccination. Low 25(OH)D levels do not explain poorer post-vaccination responses among HIV-infected persons.     

Role of Vitamin D and Vitamin D Receptor in Oral Lichen Planus: A Systematic Review

BackgroundOral lichen planus (OLP) is known to be a chronic inflammatory disease associated with various other systemic disorders. Studies have shown that vitamin D deficiency can be involved in the pathogenesis of lichen planus. The aim of this study was to investigate the role of vitamin D and vitamin D receptor in OLPMethodsIn this review study, all English and Persian articles were searched by relevant keywords from the Google scholar, PubMed, science direct, Cochrane, Scopus and Sid databases until January 2020.ResultsFrom the 16 articles obtained after reviewing the abstracts, finally 14 appropriate articles were included in this study.ConclusionAccording to the results of the studies, vitamin D deficiency may be associated with an increased risk of OLP lesions.     

Vitamin D supplementation attenuates the behavioral scores of neuropathic pain in rats

Objective(s): Neuropathic pain due to lesion or dysfunction of the peripheral or central nervous system is often refractory to the conventional analgesics. Currently, there is no proven treatment to prevent or cure neuropathic pain. A recent surge of new data suggests the potential effects of vitamin D in the medical community. This study was designed to determine whether acute or chronic vitamin D administration was effective in alleviating symptoms of neuropathic pain in a rat model of neuropathic pain.

Materials and Methods: Neuropathic pain was induced by chronic constriction injury (CCI) of the sciatic nerve in the rats that resulted in thermal hyperalgesia, mechanical, and cold allodynia.

Results: Acute vitamin D injections (250, 500, and 1000 unit/kg i.p.) on the 7th, 14th, and 21st postoperative days could not attenuate mechanical and cold allodynia as well as heat hyperalgesia compared to CCI group. But when vitamin D (1000 unit/kg i.p.) administration was started on the first day after surgery and given daily until the 21st day, cold allodynia and heat hyperalgesia considerably were attenuated. However, no differences in paw withdrawal thresholds were observed.

Conclusion: These results indicate that chronic vitamin D administrations can attenuate the behavioral scores of neuropathic pain in rats.     

Vitamin D supplementation restores suppressed synaptic plasticity in Alzheimer's disease

Objectives

Hippocampus, an appropriate area of brain for assessment of long-term potentiation (LTP), has been found to be susceptible to neural damages caused by Alzheimer's disease. Evidence indicates that vitamin D supports nerve transmission and synaptic plasticity. Vitamin D receptors are expressed in the hippocampus.

Methods

The present study evaluates occurrence of LTP in the control (CON) group fed with normal regimen and, three groups of Aβ-treated rats taking normal (ALZ), vitamin D-free (ALZ ? D), or 1,25(OH)2D3 supplemented (ALZ + D) food regimens. In in vivo experiments pre- and post-tetanus field extracellular postsynaptic potentials (fEPSPs) were recorded in the CA3–CA1 pathway.

Results

We found that the amplitude of baseline fEPSPs was significantly lower in the ALZ group compared with the CON one; lack of vitamin D further declined the amplitude of responses in the ALZ ? D animals. While the tetanic stimulation elicited a considerable LTP in the CON rats it was failed to induce LTP in the ALZ animals. Furthermore, the tetanus considerably depressed the amplitude of recordings in the ALZ ? D group. 1,25(OH)2D3 supplementation restored post-tetanus potentiation of fEPSPs amplitude in the ALZ + D groups.

Discussion

The present findings signify the crucial role of vitamin D on the basic synaptic transmission and synaptic plasticity.     

Vitamin D status in children and young adults with perinatally acquired HIV infection

Background & aims

To assess vitamin D (Vit-D) [serum 25-hydroxyvitamin D (25-OHD) concentrations] in children and young adults with perinatally acquired HIV compared to geographically similar healthy children.

Methods

25-OHD in children and young adults with HIV was compared to a healthy group. Vit-D deficiency and insufficiency were defined as 25-OHD <11 ng/mL and 25-OHD <30 ng/mL, respectively.

Results

Children with HIV (n = 81), mean age 13.8 ± 4.1 years, 48% female, 83% Black, were compared to healthy subjects (n = 372), mean age 12.4 ± 3.4 years, 51% female, 37% Black. For the HIV group, 84% were on HAART, 54% had plasma HIV RNA <400 cpm, and 35% had moderate to severe immunosuppression (CD4+ count <500 cells/mm). Vit-D deficiency/insufficiency was present in 36% and 89% of those with HIV, and 15% and 84% of the comparison group, respectively. Vit-D deficiency was more prevalent in those with HIV (unadjusted odds ratio: 3.25; 95% CI: 1.9–5.5). For both groups, prevalence of Vit-D deficiency increased with age, BMI Z-score, Black race, and in winter/spring months. Vit-D deficiency was associated with a greater degree of immunosuppression in the subjects with HIV.

Conclusions

Vit-D deficiency was increased in subjects with perinatally acquired HIV and may be associated with disease severity.