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

• Published in: The Journal of nutrition 2023-01, Vol.153 (1), p.138-147
• Main Authors: Nguyen, Hung Song, Van Tran, Khoi, Chen, Shih-Yen, Tam, Ka-Wai
• Format: Article
• Language: English
• Subjects: Adolescent; Adults; Calciferol; Child; Children; Cholecalciferol; Clinical trials; Dietary Supplements; HIV; HIV Infections - complications; Human immunodeficiency virus; Humans; Immune system; Infections; Meta-analysis; Randomized Controlled Trials as Topic; Spine; Supplements; systematic review; Vitamin D; Vitamin D Deficiency - complications; Vitamin D Deficiency - drug therapy; Vitamin deficiency; Young Adult; Young adults
• ISSN: 0022-3166; 1541-6100
• DOI: 10.1016/j.tjnut.2022.10.008

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