Vitamin D Deficiency May Cause Neurocognitive Impairment in Patients With HIV

Vitamin D deficiency can lead to cognitive dysfunction in older adults, in individuals with mental disorders, and in individuals with chronic neurologic disorders. Though combination antiretroviral therapy helped ameliorate HIV-associated dementia, neurocognitive impairment still persists.

To better understand the link between vitamin D and neurocognitive impairment in patients with HIV, the researchers conducted a retrospective, cross-sectional analysis of 542 patients undergoing neuropsychological assessment at a health care center in Italy.

Participants were assessed for cognition via a standard battery of 13 tests in 5 cognitive domains and HIV-associated neurocognitive deficit via Frascati’s criteria. Vitamin D deficiency was defined as 25 hydroxyvitamin D 25(OH)D levels less than 10 ng/mL.

Of the 542 participants included in the study, 96.7% were receiving combination antiretroviral therapy, 67.7% had vitamin D insufficiency, and 9.4% had vitamin D deficiency.

Overall, 37.1% of participants had neurocognitive impairment and 22.7% had HIV-associated neurocognitive deficit. Participants with vitamin D deficiency had higher rates of neurocognitive impairment (52.9% vs 35.4%) and HIV-associated neurocognitive deficit (42.9% vs 24.9%) compared with those with higher vitamin D levels.

Results of multivariable analyses showed that vitamin D deficiency was the only risk factor for neurocognitive impairment or HIV-associated neurocognitive deficit.

“In HIV-positive persons, severe hypovitaminosis D was independently associated with a higher risk of neurocognitive impairment in general, and of HIV-associated neurocognitive disorders in particular,” the researchers concluded. “Future studies are needed to elucidate causal relationship and whether vitamin D supplementation may reverse this risk.”

—Amanda Balbi

Reference:

Vergori A, Pinnetti C, Lorenzini P, et al. Vitamin D deficiency is associated with neurocognitive impairment in HIV-infected subjects [published online June 10, 2019]. Infection. https://doi.org/10.1007/s15010-019-01313-6.