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Is vitamin D deficiency involved in the immune reconstitution inflammatory syndrome?

par Conesa-Botella, Anali;Mathieu, Chantal;Colebunders, Robert Leon;Moreno Reyes, Mario Rodrigo ;van Etten, Evelyne;Lynen, Lut;Kestens, Luc
Référence AIDS Research and Therapy, 6, 4
Publication Publié, 2009-04

Article révisé par les pairs

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Résumé :

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 the 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 due to polymorphisms in the vitamin D receptor or in its activating/ inactivating enzymes, contributes to the appearance of IRIS. Furthermore, drug interactions with the enzymatic pathways of vitamin D 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. © 2009 Conesa-Botella et al; licensee BioMed Central Ltd.