Abstract
BACKGROUND: Beyond its role in calcium homeostasis, vitamin D plays a critical role in immunological responses to pathogens. We evaluated the relationship between 25-OH vitamin D levels and susceptibility to natural H1N1 infection and H1N1 vaccine responses in HIV infected individuals. METHODS: This was a sub study of an H1N1 vaccine trial conducted at the University of Pennsylvania in 2009/10. We compared the 25-OH vitamin D levels among individuals with and without baseline evidence of prior H1N1 infection and between vaccine responders and non-responders. RESULTS: 120 participants enrolled in the trial, 71% male, 68% African American, median age 46 years. The majority had controlled HIV disease. At baseline, 86% had 25-OH vitamin D levels < 30 ng/ml and 54% had levels < 20 ng/ml. Thirty participants (25%) had evidence of prior H1N1 exposure. There was no difference in mean 25-OH vitamin D levels among patients with or without prior natural H1N1 infection (21 ng/ml vs 20 ng/ml, p=0.72). Among participants without previous H1N1 exposure, only 61% developed protective antibody titers following vaccination. 25-OH vitamin D levels were similar between vaccine responders (20 ng/ml) and non-responders (20 ng/ml) (p=0.83). CONCLUSION: Although 25-OH vitamin D deficiency was very common among HIV-infected individuals, it was not associated with natural susceptibility to H1N1 or to vaccine responses.
Highlights
Twenty-five hydroxy (25-our sample had 25 (OH)) vitamin D deficiency is highly prevalent among HIV-infected adults [1,2,3] and has well-established consequences on bone mineralization and calcium homeostasis
This study examined the prevalence of vitamin D deficiency in HIV-infected individuals and its relationship to prior H1N1 exposure and immunologic response to H1N1 vaccination
In this prospective study of patients with HIV receiving the H1N1 vaccine, we found that there was no difference in the mean vitamin D levels between patients with or without prior natural H1N1 infection or between vaccine responders and non-responders
Summary
Twenty-five hydroxy (25-OH) vitamin D deficiency is highly prevalent among HIV-infected adults [1,2,3] and has well-established consequences on bone mineralization and calcium homeostasis. In vitro [7,8,9] and in vivo [10,11] studies have demonstrated the ability of vitamin D to up-regulate immunological responses through activation of human macrophages [7], monocyte chemotaxis [8], oxidative burst [9], and other mechanisms [8,9]. This study examined the prevalence of vitamin D deficiency in HIV-infected individuals and its relationship to prior H1N1 exposure and immunologic response to H1N1 vaccination. We compared the 25-OH vitamin D levels among individuals with and without baseline evidence of prior H1N1 infection and between vaccine responders and nonresponders. Conclusion— 25-OH vitamin D deficiency was very common among HIV-infected individuals, it was not associated with natural susceptibility to H1N1 or to vaccine responses
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