A Systematic Review and Meta-Analysis of Randomized Controlled Trials of the Effects of Vitamin D Supplementation on Children and Young Adults with HIV Infection

Hung Song Nguyen; Khoi Van Tran; Shih-Yen Chen; Ka-Wai Tam

doi:10.1016/j.tjnut.2022.10.008

A Systematic Review and Meta-Analysis of Randomized Controlled Trials of the Effects of Vitamin D Supplementation on Children and Young Adults with HIV Infection

J Nutr. 2023 Jan;153(1):138-147. doi: 10.1016/j.tjnut.2022.10.008. Epub 2022 Dec 20.

Authors

Hung Song Nguyen¹, Khoi Van Tran², Shih-Yen Chen³, Ka-Wai Tam⁴

Affiliations

¹ International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan; Division of Infectious Disease, Department of Pediatrics, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam; Infectious Disease Department, Children's Hospital 2, Ho Chi Minh City, Vietnam.
² International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan.
³ Division of Allergy, Asthma, and Immunology, Department of Pediatrics, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan.
⁴ Center for Evidence-based Health Care, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Cochrane Taiwan, Taipei Medical University, Taipei City, Taiwan; Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan. Electronic address: kelvintam@h.tmu.edu.tw.

PMID: 36913447
DOI: 10.1016/j.tjnut.2022.10.008

Abstract

Background: Children and young adults with HIV infection may exhibit vitamin D deficiency, which is harmful to bone health as well as the endocrine and immune systems.

Objectives: This study sought to investigate the effect of vitamin D supplementation on children and young adults with HIV infection.

Methods: The PubMed, Embase, and Cochrane databases were searched. Randomized controlled trials that have evaluated the effects of vitamin D supplementation (ergocalciferol or cholecalciferol) at any dose or for any duration in children and young adults with HIV infection, aged 0-25 y, were included. A random-effects model was used, and the standardized mean difference (SMD) and 95% CI were calculated.

Results: Ten trials, with 21 publications and 966 participants (mean age: 17.9 y), were included in the meta-analysis. The supplementation dose and the duration of the studies included ranged from 400 to 7000 IU/d and from 6 to 24 mo, respectively. Vitamin D supplementation was associated with a significantly higher serum 25(OH)D concentration at 12 mo (SMD: 1.14; 95% CI: 0.64, 1.65; P < 0.00001) compared with a placebo. No significant difference was observed in spine BMD (SMD: -0.09; 95% CI: -0.47, 0.3; P = 0.65) at 12 mo between these 2 groups. However, participants who received higher doses (1600-4000 IU/d) had significantly higher total BMD (SMD: 0.23; 95% CI: 0.02, 0.44; P = 0.03) and nonsignificantly higher spine BMD (SMD: 0.3; 95% CI: -0.02, 0.61; P = 0.07) at 12 mo compared with those who received standard doses (400-800 IU/d).

Conclusions: Vitamin D supplementation in children and young adults with HIV infection increases the serum 25(OH)D concentration. A relatively high daily dose of vitamin D (1600-4000 IU) improves total BMD at 12 mo and results in sufficient 25(OH)D concentrations.

Keywords: HIV; children; meta-analysis; systematic review; vitamin D; young adults.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Adolescent
Child
Cholecalciferol
Dietary Supplements
HIV Infections* / complications
Humans
Randomized Controlled Trials as Topic
Vitamin D
Vitamin D Deficiency* / complications
Vitamin D Deficiency* / drug therapy
Young Adult

Substances

Vitamin D
Cholecalciferol