Serum vitamin D levels are positively associated with varicella zoster immunity in chronic dialysis patients

• Published in: Scientific reports 2014-12, Vol.4 (1), p.7371, Article 7371
• Main Authors: Chao, Chia-Ter, Lee, Szu-Ying, Yang, Wei-Shun, Yen, Chung-Jen, Chiang, Chih-Kang, Huang, Jenq-Wen, Hung, Kuan-Yu
• Format: Article
• Language: English
• Subjects: 692/699/1585; 692/699/2743; Aged; Antibodies, Viral - blood; Antibodies, Viral - immunology; Bioavailability; Cancer; Chicken pox; Comorbidity; Female; Hemodialysis; Herpes zoster; Herpes Zoster - blood; Herpes Zoster - etiology; Herpesvirus 3, Human - immunology; Hormones - blood; Humanities and Social Sciences; Humans; Immunity; Immunocompromised Host; Immunoglobulin G; Immunoglobulin G - blood; Immunoglobulin G - immunology; Immunoglobulin M; Immunoglobulin M - blood; Immunoglobulin M - immunology; Male; Middle Aged; Minerals - metabolism; multidisciplinary; Prospective Studies; Renal Dialysis - adverse effects; Science; Uremia; Varicella; Vitamin D; Vitamin D - analogs & derivatives; Vitamin D - blood; Vitamin D-binding protein
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/srep07371

Uremia results in a relatively immunocompromised status and patients under chronic dialysis have an elevated risk of developing herpes zoster (HZ). We sought to investigate the relationship between vitamin D status and immunity to varicella-zoster virus (VZV). A multicenter prevalent hemodialysis cohort was assembled between 2012 and 2013. We assayed the biochemical parameters, 25-hydroxy- (25-OH-D) and 1,25-dihydroxyvitamin D, vitamin D-binding protein levels in the sera. VZV immunity was quantitated using VZV-specific glycoprotein IgG and IgM titers. Eighty-eight patients were enrolled and their sera were analyzed. Chronic hemodialysis patients with 25-OH-D < 30 ng/ml (insufficiency or deficiency) had significantly lower VZV-IgG than those with sufficient 25-OH-D ( p = 0.04). This discrepancy became more prominent if active vitamin D users alone were analyzed ( p = 0.01). Generalized additive modeling showed that those with 25-OH-D higher than 27.8 ng/ml or bioavailable 25-OH-D higher than 3.88 ng/ml had significantly higher VZV-IgG levels than those with lower values. Linear regression suggested that both total and bioavailable 25-OH-D were significantly associated with higher VZV-IgG levels ( p = 0.003 [total] and 0.01 [bioavailable]), whereas patients with cancer had lower VZV-IgG. Vitamin D may therefore be a potentially useful choice for raising VZV immunity in chronic dialysis patients.