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dc.contributor.authorSudfeld, Christopher Robert
dc.contributor.authorWang, Molin
dc.contributor.authorAboud, Said
dc.contributor.authorGiovannucci, Edward L.
dc.contributor.authorMugusi, Ferdinand M.
dc.contributor.authorFawzi, Wafaie W.
dc.date.accessioned2013-03-18T19:19:35Z
dc.date.issued2012
dc.identifier.citationSudfeld, Christopher R., Molin Wang, Said Aboud, Edward L. Giovannucci, Ferdinand M. Mugusi, and Wafaie W. Fawzi. 2012. Vitamin d and hiv progression among tanzanian adults initiating antiretroviral therapy. PLoS ONE 7(6): e40036.en_US
dc.identifier.issn1932-6203en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:10436322
dc.description.abstractBackground: There is growing evidence of an association between low vitamin D and HIV disease progression; however, no prospective studies have been conducted among adults receiving antiretroviral therapy (ART) in sub-Saharan Africa. Methods Serum 25-hydroxyvitamin D (25(OH)D) levels were assessed at ART initiation for a randomly selected cohort of HIV-infected adults enrolled in a trial of multivitamins (not including vitamin D) in Tanzania during 2006–2010. Participants were prospectively followed at monthly clinic visits for a median of 20.6 months. CD4 T-cell measurements were obtained every 4 months. Proportional hazard models were utilized for mortality analyses while generalized estimating equations were used for CD4 T-cell counts. Results: Serum 25(OH)D was measured in 1103 adults 9.2% were classified as vitamin D deficient (<20 ng/ml), 43.6% insufficient (20–30 ng/mL), and 47.2% as sufficient (>30 ng/mL). After multivariate adjustment, vitamin D deficiency was significantly associated with increased mortality as compared to vitamin D sufficiency (HR: 2.00; 95% CI: 1.19–3.37; p = 0.009), whereas no significant association was found for vitamin D insufficiency (HR: 1.24; 95% CI: 0.87–1.78; p = 0.24). No effect modification by ART regimen or change in the associations over time was detected. Vitamin D status was not associated with change in CD4 T-cell count after ART initiation. Conclusions: Deficient vitamin D levels may lead to increased mortality in individuals receiving ART and this relationship does not appear to be due to impaired CD4 T-cell reconstitution. Randomized controlled trials are needed to determine the safety and efficacy of vitamin D supplementation for individuals receiving ART.en_US
dc.language.isoen_USen_US
dc.publisherPublic Library of Scienceen_US
dc.relation.isversionofdoi:10.1371/journal.pone.0040036en_US
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3386915/pdf/en_US
dash.licenseLAA
dc.subjectBiologyen_US
dc.subjectMicrobiologyen_US
dc.subjectVirologyen_US
dc.subjectAntiviralsen_US
dc.subjectMedicineen_US
dc.subjectClinical Research Designen_US
dc.subjectCohort Studiesen_US
dc.subjectInfectious Diseasesen_US
dc.subjectSexually Transmitted Diseasesen_US
dc.subjectAIDSen_US
dc.subjectViral Diseasesen_US
dc.subjectHIVen_US
dc.subjectHIV clinical manifestationsen_US
dc.subjectHIV epidemiologyen_US
dc.subjectHIV opportunistic infectionsen_US
dc.subjectNutritionen_US
dc.subjectVitaminsen_US
dc.titleVitamin D and HIV Progression among Tanzanian Adults Initiating Antiretroviral Therapyen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalPLoS ONEen_US
dash.depositing.authorSudfeld, Christopher Robert
dc.date.available2013-03-18T19:19:35Z
dc.identifier.doi10.1371/journal.pone.0040036*
dash.contributor.affiliatedWang, Molin
dash.contributor.affiliatedFawzi, Wafaie
dash.contributor.affiliatedSudfeld, Christopher
dash.contributor.affiliatedGiovannucci, Edward


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