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Very Low Levels of 25-Hydroxyvitamin D Are Not Associated With Immunologic Changes or Clinical Outcome in South African Patients With HIV-Associated Cryptococcal Meningitis

Jarvis, JN; Bicanic, T; Loyse, A; Meintjes, G; Hogan, L; Roberts, CH; Shoham, S; Perfect, JR; Govender, NP; Harrison, TS (2014) Very Low Levels of 25-Hydroxyvitamin D Are Not Associated With Immunologic Changes or Clinical Outcome in South African Patients With HIV-Associated Cryptococcal Meningitis. Clin Infect Dis, 59 (4). 493 - 500. ISSN 1058-4838 https://doi.org/10.1093/cid/ciu349
SGUL Authors: Harrison, Thomas Stephen Bicanic, Tihana Loyse, Angela

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Abstract

Background. Vitamin D deficiency is associated with impaired immune responses and increased susceptibility to a number of intracellular pathogens in individuals infected with human immunodeficiency virus (HIV). It is not known whether such an association exists with Cryptococcus neoformans. Methods. Levels of 25-hydroxyvitamin D (25[OH]D) were measured in 150 patients with cryptococcal meningitis (CM) and 150 HIV-infected controls in Cape Town, South Africa, and associations between vitamin D deficiency and CM were examined. The 25-hydroxyvitamin D levels and cryptococcal notifications were analyzed for evidence of reciprocal seasonality. Associations between 25(OH)D levels and disease severity, immune responses, and microbiological clearance were investigated in the patients with CM. Results. Vitamin D deficiency (plasma 25[OH]D ≤50 nmol/L) was present in 74% of patients. Vitamin D deficiency was not associated with CM (adjusted odds ratio, 0.93 [95% confidence interval, .6–1.6]; P = .796). Levels of 25(OH)D showed marked seasonality, but no reciprocal seasonality was seen in CM notifications. No significant associations were found between 25(OH)D levels and fungal burden or levels of tumor necrosis factor α, interferon γ, interleukin 6, soluble CD14, or neopterin in cerebrospinal fluid. Rates of fungal clearance did not vary according to vitamin D status. Conclusions. Vitamin D deficiency does not predispose to the development of CM, or lead to impaired immune responses or microbiological clearance in HIV-infected patients with CM.

Item Type: Article
Additional Information: © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.This is an OpenAccess article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/ .0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: HIV, South Africa, cryptococcal meningitis, tuberculosis, vitamin D, Microbiology, 06 Biological Sciences, 11 Medical And Health Sciences, HIV, South Africa, cryptococcal meningitis, tuberculosis, vitamin D
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Clin Infect Dis
ISSN: 1058-4838
Related URLs:
Dates:
DateEvent
15 August 2014Published
PubMed ID: 24825871
Web of Science ID: 24825871
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/107126
Publisher's version: https://doi.org/10.1093/cid/ciu349

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