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Very low levels of 25-hydroxyvitamin D are not associated with immunologic changes or clinical outcome in South African patients with HIV-associated cryptococcal meningitis.

Publication ,  Journal Article
Jarvis, JN; Bicanic, T; Loyse, A; Meintjes, G; Hogan, L; Roberts, CH; Shoham, S; Perfect, JR; Govender, NP; Harrison, TS
Published in: Clin Infect Dis
August 15, 2014

BACKGROUND: Vitamin D deficiency is associated with impaired immune responses and increased susceptibility to a number of intracellular pathogens in individuals infected with human immunodeficiency virus (HIV). It is not known whether such an association exists with Cryptococcus neoformans. METHODS: Levels of 25-hydroxyvitamin D (25[OH]D) were measured in 150 patients with cryptococcal meningitis (CM) and 150 HIV-infected controls in Cape Town, South Africa, and associations between vitamin D deficiency and CM were examined. The 25-hydroxyvitamin D levels and cryptococcal notifications were analyzed for evidence of reciprocal seasonality. Associations between 25(OH)D levels and disease severity, immune responses, and microbiological clearance were investigated in the patients with CM. RESULTS: Vitamin D deficiency (plasma 25[OH]D ≤50 nmol/L) was present in 74% of patients. Vitamin D deficiency was not associated with CM (adjusted odds ratio, 0.93 [95% confidence interval, .6-1.6]; P = .796). Levels of 25(OH)D showed marked seasonality, but no reciprocal seasonality was seen in CM notifications. No significant associations were found between 25(OH)D levels and fungal burden or levels of tumor necrosis factor α, interferon γ, interleukin 6, soluble CD14, or neopterin in cerebrospinal fluid. Rates of fungal clearance did not vary according to vitamin D status. CONCLUSIONS: Vitamin D deficiency does not predispose to the development of CM, or lead to impaired immune responses or microbiological clearance in HIV-infected patients with CM.

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Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

August 15, 2014

Volume

59

Issue

4

Start / End Page

493 / 500

Location

United States

Related Subject Headings

  • Vitamin D Deficiency
  • Vitamin D
  • Treatment Outcome
  • South Africa
  • Seasons
  • Neopterin
  • Microbiology
  • Meningitis, Cryptococcal
  • Male
  • Lipopolysaccharide Receptors
 

Citation

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Jarvis, J. N., Bicanic, T., Loyse, A., Meintjes, G., Hogan, L., Roberts, C. H., … Harrison, T. S. (2014). Very low levels of 25-hydroxyvitamin D are not associated with immunologic changes or clinical outcome in South African patients with HIV-associated cryptococcal meningitis. Clin Infect Dis, 59(4), 493–500. https://doi.org/10.1093/cid/ciu349
Jarvis, Joseph N., Tihana Bicanic, Angela Loyse, Graeme Meintjes, Louise Hogan, Chrissy H. Roberts, Shmuel Shoham, John R. Perfect, Nelesh P. Govender, and Thomas S. Harrison. “Very low levels of 25-hydroxyvitamin D are not associated with immunologic changes or clinical outcome in South African patients with HIV-associated cryptococcal meningitis.Clin Infect Dis 59, no. 4 (August 15, 2014): 493–500. https://doi.org/10.1093/cid/ciu349.
Jarvis JN, Bicanic T, Loyse A, Meintjes G, Hogan L, Roberts CH, et al. Very low levels of 25-hydroxyvitamin D are not associated with immunologic changes or clinical outcome in South African patients with HIV-associated cryptococcal meningitis. Clin Infect Dis. 2014 Aug 15;59(4):493–500.
Jarvis, Joseph N., et al. “Very low levels of 25-hydroxyvitamin D are not associated with immunologic changes or clinical outcome in South African patients with HIV-associated cryptococcal meningitis.Clin Infect Dis, vol. 59, no. 4, Aug. 2014, pp. 493–500. Pubmed, doi:10.1093/cid/ciu349.
Jarvis JN, Bicanic T, Loyse A, Meintjes G, Hogan L, Roberts CH, Shoham S, Perfect JR, Govender NP, Harrison TS. Very low levels of 25-hydroxyvitamin D are not associated with immunologic changes or clinical outcome in South African patients with HIV-associated cryptococcal meningitis. Clin Infect Dis. 2014 Aug 15;59(4):493–500.
Journal cover image

Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

August 15, 2014

Volume

59

Issue

4

Start / End Page

493 / 500

Location

United States

Related Subject Headings

  • Vitamin D Deficiency
  • Vitamin D
  • Treatment Outcome
  • South Africa
  • Seasons
  • Neopterin
  • Microbiology
  • Meningitis, Cryptococcal
  • Male
  • Lipopolysaccharide Receptors