Is vitamin D deficiency involved in the immune reconstitution inflammatory syndrome?Is vitamin D deficiency involved in the immune reconstitution inflammatory syndrome?
Faculty of Pharmaceutical, Biomedical and Veterinary Sciences. Pharmacy
Faculty of Medicine and Health Sciences
Epidemiology and social medicine (ESOC)
Laboratory for Microbiology, Parasitology and Hygiene (LMPH)
Aids research and therapy. - London
6(2009), p. 4,1-4,18
University of Antwerp
Background About 20-30% of persons with HIV infection, especially those living in countries with limited resources, experience an immune reconstitution inflammatory syndrome (IRIS) after starting antiretroviral treatment. The active form of vitamin D, 1,25-dihydroxyvitamin D, is a key player in clearance of pathogens and influences the level of inflammation and macrophage activation. Presentation of the hypothesis We hypothesize that low availability of 1,25-dihydroxyvitamin D, either due to vitamin D deficiency or to polymorphisms in vitamin D receptor or its activating/inactivating enzymes, contributes to the appearance of IRIS. Furthermore, drug interactions with vitamin D enzymatic pathways could favour the development of IRIS. Testing the hypothesis Our hypothesis could be explored by a case-control study to assess the prevalence of vitamin D deficiency in HIV-infected patients on antiretroviral treatment who develop and do not develop IRIS. Implications of the hypothesis If the role of vitamin D in IRIS is confirmed, we would be able to screen patients at risk for IRIS by screening for vitamin D deficiency. After confirmation by means of a clinical trial, vitamin D supplementation could be a cheap and safe way to reduce the incidence of IRIS.