期刊
BRITISH JOURNAL OF NUTRITION
卷 116, 期 10, 页码 1720-1727出版社
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0007114516003743
关键词
HIV; Vitamin D; Nutritional intervention; Antiretroviral treatment
资金
- US Dairy Export Council
- Ministry of Foreign Affairs of Denmark
Low vitamin D level in HIV-positive persons has been associated with disease progression. We compared the levels of serum 25-hydroxyvitamin D (25(OH) D) in HIV-positive and HIV-negative persons, and investigated the role of nutritional supplementation and antiretroviral treatment (ART) on serum 25(OH) D levels. A randomised nutritional supplementation trial was conducted at Jimma University Specialized Hospital, Ethiopia. The trial compared 200 g/d of lipid-based nutrient supplement (LNS) with no supplementation during the first 3 months of ART. The supplement provided twice the recommended daily allowance of vitamin D (10 mu g/200 g). The level of serum 25(OH) D before nutritional intervention and ART initiation was compared with serum 25(OH) D of HIV-negative individuals. A total of 348 HIV-positive and 100 HIV-negative persons were recruited. The median baseline serum 25(OH) D level was higher in HIV-positive than in HIV-negative persons (42 5 v. 35.3 nmol/l, P <0.001). In all, 282 HIV-positive persons with BMI > 17 kg/m(2) were randomised to either LNS supplementation (n 189) or no supplementation (n 93) during the first 3 months of ART. The supplemented group had a 4.1 (95% CI 1.7, 6.4) nmol/l increase in serum 25(OH) D, whereas the non-supplemented group had a 10.8 (95% CI 7.8, 13.9) nmol/l decrease in serum 25(OH) D level after 3 months of ART. Nutritional supplementation that contained vitamin D prevented a reduction in serum 25(OH) D levels in HIV-positive persons initiating ART. Vitamin D replenishment may be needed to prevent reduction in serum 25(OH) D levels during ART.
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