Association of vitamin D with HIV infected individuals, TB infected individuals, and HIV-TB co-infected individuals: a systematic review and meta-analysis

Front Public Health. 2024 Feb 14:12:1344024. doi: 10.3389/fpubh.2024.1344024. eCollection 2024.

Abstract

Background: Vitamin D deficiency (VDD) is a worldwide disease. VDD is also associated with an increased risk of HIV-related comorbidities and mortality, and patients have a tendency to develop active tuberculosis compared to those with latent tuberculosis infection. Vitamin D supplementation may modulate HIV replication, improve TB inflammation and reduce progression of HIV-TB co-infection.

Methods: We meta-analyzed individual participant data from cohort studies, cross-sectional study, and RCTs of vitamin D in HIV group, TB group, and HIV-TB group. The primary outcomes were differences in vitamin D level and VDD prevalence between three groups, the secondary outcomes were CD4 count, HIV viral load, time to sputum smear conversion, time to culture conversion, relapse, morality, and TB score.

Results: For vitamin D levels, the overall mean difference (MD) between HIV group and TB group was -0.21 (95% CI, -20.80-20.38; p = 0.9, I2 = 84%), HIV group and HIV-TB group was 0.87 (95% CI, -11.45-13.20; p = 0.89, I2 = 87%), and TB group and HIV-TB group was 1.17 (95% CI, -5.21-7.55; p = 0.72, I2 = 85%). For vitamin D deficiency prevalence, the overall odds ratio (OR) for HIV group versus TB group was 1.23 (95% CI, 0.46-3.31; p = 0.68; I2 = 70%), HIV group versus HIV-TB group was 1.53 (95% CI, 1.03-2.29; p = 0.04; I2 = 0%), and TB group versus HIV-TB group was 0.85 (95% CI, 0.61-1.20; p = 0.36; I2 = 22%). In HIV-TB group, the overall OR for vitamin D group versus placebo group was 0.78 (95% CI, 0.34-1.67; p = 0.52; I2 = 60%).

Conclusion: Our findings indicated that there were no variations in vitamin D levels between three groups. The prevalence of vitamin D deficiency was higher in the HIV-TB group than in the HIV group. Additionally, the administration of vitamin D supplements did not have obvious impact on CD4 count and viral load. Likewise, vitamin D had no effect on time to sputum smear conversion, time to culture conversion, relapse, 12-month morality, and TB score.

Keywords: HIV; HIV-TB; TB; prevalence; supplementation vitamin D; vitamin D deficiency.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Coinfection* / epidemiology
  • Cross-Sectional Studies
  • HIV Infections* / complications
  • HIV Infections* / epidemiology
  • Humans
  • Recurrence
  • Vitamin D
  • Vitamin D Deficiency* / epidemiology
  • Vitamins

Substances

  • Vitamin D
  • Vitamins

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This research was funded by the National Natura Science Foundation of China (82072271 to TZ, 82241072 to TZ, 82072294 to ZL), the Beijing Natural Science Foundation (7222091 to YZ), the High-level Public Health Technical Personnel Construction Project (2020-1-007 to TZ), and the Beijing Key Laboratory for HIV/AIDS Research (BZ0089 to TZ), the High-level Public Health Specialized Talents Project of Beijing Municipal Health commission (2022-02-20 to ZL), the Peak Talent Program of Beijing Hospital Authority (DFL20191701 to TZ), the Capital’s Funds for Healthy Improvement and Research (2022-1-1151 to TZ), the Research and Translational Application of Clinical Characteristic Diagnostic and Treatment Techniques in Capital City (Z221100007422055 to TZ), the Beijing Hospitals Authority Innovation Studio of Young Staff Funding Support (2021037 to YZ).