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Free Content Low prevalence of vitamin D deficiency in Ugandan HIV-infected patients with and without tuberculosis

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Abstract:

OBJECTIVE: To examine whether hypovitaminosis D is a risk factor for the development of tuberculosis (TB) associated immune reconstitution inflammatory syndrome (IRIS).

METHODS: We measured serum 25-hydroxyvitamin D (25D) concentrations in four groups of patients at Mulago Hospital, Kampala, Uganda: 1) patients co-infected with TB and the human immunodeficiency virus (HIV) receiving anti-tuberculosis treatment (HIV+TB+; n = 92) who did and did not develop TB-IRIS after starting antiretroviral treatment (ART), 2) HIV-infected patients without TB (HIV+TB−; n = 20) starting ART, 3) non-HIV-infected individuals with TB (HIV−TB+; n = 27), and 4) those without TB (HIV−TB−; n = 23).

RESULTS: The prevalence of optimal 25D levels (>75 nmol/l) was as follows: 59% in HIV+TB+, 65% in HIV+TB−, 63% in HIV−TB+ and 35% in HIV−TB− patients. 25D concentrations decreased during the first 3 months of ART in HIV+TB+ individuals who developed IRIS (P = 0.005) and those who did not (P = 0.002), and in HIV+TB− individuals (P = 0.015); however, 25D concentration in patients who did or did not develop TB-IRIS did not differ.

CONCLUSION: The prevalence of optimal vitamin D status was relatively high in HIV-infected patients with and without TB living near the equator. No difference in 25D concentrations was observed between TB-IRIS and non-IRIS. However, 25D concentrations decreased during ART.

Keywords: 25-hydroxyvitamin D; HAART; immune reconstitution

Document Type: Research Article

DOI: http://dx.doi.org/10.5588/ijtld.11.0146

Affiliations: 1: Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium 2: Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium 3: Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium 4: Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda; Department of Internal Medicine, Makerere University College of Health Sciences/Mulago Hospital, Kampala, Uganda; Infectious Diseases Network for Treatment and Research in Africa (INTERACT), Kampala, Uganda 5: Department of Internal Medicine, Makerere University College of Health Sciences/Mulago Hospital, Kampala, Uganda; Infectious Diseases Network for Treatment and Research in Africa (INTERACT), Kampala, Uganda 6: Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda; Department of Internal Medicine, Makerere University College of Health Sciences/Mulago Hospital, Kampala, Uganda

Publication date: November 1, 2012

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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