Begins enrolling children and young adults, HIV and non-HIV, in studies
8-Nov-2011 - CLEVELAND - While Vitamin D is essential for proper bone health, a number of research
studies have linked it to guarding against cardiovascular disease and certain cancers. It is unique among vitamins
in that it is made by the body in response to sunlight but is naturally present in very few foods. Recent studies
have confirmed that vitamin D deficiency is common, even in sunny states such as Florida.
People who are HIV-positive, of all ages and all races, may be at particularly high risk of having vitamin D
deficiency, in part, because certain HIV medications appear to lower vitamin D levels.
University Hospitals (UH) Rainbow Babies & Children's Hospital will be looking at the role of Vitamin D in
preventing heart disease in children and young adults who are both HIV-positive and HIV-negative. The studies
are being led by Grace McComsey, M.D., Division Chief, Pediatric Infectious Diseases, Rheumatology & Global Child
Health at UH Rainbow Babies & Children's Hospital and a Professor of Pediatrics at Case Western Reserve University
School of Medicine.
"In HIV-positive populations now, we have made great strides in helping patients live productive lives with the
help of medications," said Dr. McComsey. "However, we are finding that patients are experiencing higher rates
of heart disease and cancer."
While children and young adults with HIV may not yet experience outward symptoms of heart disease at their age,
ultrasounds are already revealing abnormal vessel thickness or plaques compared to healthy youth. These kids
are at a significantly higher risk than the general population for heart disease. In adults with HIV,
research has shown that the risk of heart disease rises by 26 percent for every year of treatment.
For these kids who will likely be on HIV medications for decades, heart disease is an important risk.
"The large success we have had in helping them live longer through HIV medications is now threatened by an increase
risk of heart disease," said Dr. McComsey.
Dr. McComsey said the increased risk is due at least in part, to heightened inflammation in these patients and that
several studies had indicated that deficiency in Vitamin D may increase inflammation and heart disease risk.
In two new UH Rainbow Babies & Children's Hospital studies, a total of 240 HIV-positive and 240 HIV-negative
patients will be studied to understand how Vitamin D deficiency affects inflammation, immune system and risk of
heart disease. Also, participants with low vitamin D levels will be randomly assigned to one of three oral
dose levels of monthly vitamin D to determine which dose may be the best for reducing heart disease,
inflammation as well as boosting the immune system and bone density.
Heart and bone disease, inflammation and immune system function will be measured through biomarkers found in
blood and urine samples, and through ultrasound tests that can reveal blockage in arteries and measure
thickness of bone. The researchers will also look at the effect of HIV medications on accelerating
vitamin D deficiency.
"Vitamin D may present a safe opportunity to reverse the increased cardiovascular disease risk and immune
co-morbidities in the HIV population," said Dr. McComsey. "Optimizing Vitamin D concentrations early in
the course of HIV infection could offer a simple and cost-effective approach to minimize the risk
of HIV-related heart disease and preserve immune function."
In the non-HIV study, researchers are hoping to also find an optimal level of Vitamin D that will help decrease
heart risk and inflammation. That is because, similar to the case in HIV, data is also surfacing in the general
population linking low vitamin D in the blood to higher risk of heart disease and cancer, both thought to be
possibly the result of high inflammation and/or altered immune status.
he two-year study is funded by a five-year grant from the National Institutes of Health to Case Western
Reserve University School of Medicine. Also participating in this study is Emory University and the Grady
Health System in Atlanta.
For information about enrollment in the trial, please call 216-844-2752.
About University Hospitals Rainbow Babies & Children's Hospital
Located on the campus of University Hospitals Case Medical Center in Cleveland, Ohio, University Hospitals
Rainbow Babies & Children's Hospital is a 244-bed, full-service pediatric hospital and academic medical
center, solely dedicated to the health care needs of children. A trusted leader in children's health care
for more than 125 years, UH Rainbow Babies & Children's Hospital consistently ranks among the top
children's hospitals in the nation. As the region's premier resource for pediatric referrals,
UH Rainbow Babies & Children's Hospital's dedicated team of more than 1,300 pediatric
specialists uses the most advanced treatments and latest innovations to deliver the
complete range of pediatric specialty services to approximately 9,000 inpatients
and 550,000 outpatients each year. Learn more at http://www.RainbowBabies.org
Contact: George Stamatis
University Hospitals Case Medical Center