people with hiv are living decades longer than before due to combination art ; however , complications including cvd < osteoporosis and non aids defining malignancies are higher than in the general population .
many of the emerging complications related to chronic hiv infection represent disease processes where vitamin d is known to play an important role .
a single point cross sectional case control study was conducted in a tertiary care hospital to determine the prevalence of vitamin d deficiency and its association with carotid intima media thickness ( cimt ) in hiv patients and to study the association of lipid profile with hiv infection . out of the 45 hiv positive cases ,
vitamin d deficiency was found in 42 cases ( 93.33% ) whereas only 33 out of 45 ( 73.33% ) healthy controls .
a positive association was seen between cd4 levels and 25 hydroxy vitamin d. an inverse co - relation between cd4 count and triglycerides and vldl levels while a positive co - relation with total cholesterol , ldl cholesterol and hdl cholesterol levels was seen .
people infected with hiv-1 are at an increased risk of cardiovascular disease ( cvd ) .
hiv - infected adults have increased levels of proinflammatory cytokines and endothelial activation markers , which have been associated with cvd in the general population .
in addition , the carotid intima - media thickness ( cimt ) , a surrogate marker for atherosclerosis , is associated with levels of proinflammatory cytokines and endothelial activation markers .
dyslipidemia is an important metabolic change that may occur in individuals with hiv infection which may contribute to cardiovascular disease .
the present study was conducted with the aim to determine the prevalence of vitamin d deficiency and its association with carotid intima media thickness in hiv patients and to study the correlation of lipid profile and hiv infection .
the study was conducted in a tertiary care hospital in allahabad from july 2011 to july 2012 .
forty - five hiv positive cases diagnosed by elisa , who were 18 years and above and 45 healthy age and sex matched controls were studied .
thorough clinical and biochemical examination was done for all cases and controls and they were assessed for fasting blood glucose , fasting lipid profile , hiv 1 and 2 , cd4 count , ecg , cimt , 25(oh)vitamin d.
out of the 45 hiv + ve cases , vitamin d deficiency ( 25(oh ) d levels < 30 ng / ml ) was found in 42 cases ( 93.33% ) and 33 out of the 45 ( 73.33% ) age and sex matched healthy controls .
twenty - three cases ( 51.11% ) and only 7 controls ( 15.5% ) has deranged lipid profile ( p = .
cases were grouped into 4 groups according to their cd4 counts : > 500/mm , 201 - 500/mm , 50 - 200/mm , and < 50/mm . an inverse relationship between cd4 count and triglyceride levels ( r value = -0.221 ) and vldl levels ( r value = -0.234 )
was seen while a gradual decline of total cholesterol levels , ldl levels and hdl levels with decreasing cd4 count was observed ( r values = 0.057 , 0.013 and 0.217 respectively ) .
out of the 45 cases , none ( 0% ) had cimt<6 mm , 23(51.11% ) had cimt measuring 6 mm , 7 ( 15.55% ) had cimt measuring 7 mm , 15 ( 13.33% ) had cimt measuring 8 mm and none ( 0% ) measuring > 8 mm compared to controls with 1 ( 2.22% ) who had cimt < 6 mm , 16(35.55% ) with cimt measuring 7 mm , 19 ( 42.22% ) had cimt measuring 7 mm , 9 ( 20% ) had cimt measuring 8 mm and none ( 0% ) measuring > 8 mm . by using statistical analysis , no significant difference in
the cimt of hiv positive cases and hiv negative controls was present ( p = 1.00 ) .
in this study , the prevalence of vitamin d deficiency in hiv positive cases was 93.33% as compared to a prevalence of 66.66% in the healthy population .
lipid profile , in the present study was altered with a prevalence of 51.11% in hiv infected population and 15.55% in the healthy population .
alteration in the lipid profile occurred even during the early stages of hiv infection and , more so , as the disease progressed .
the fasting total cholesterol , hdl and ldl were significantly lower in the hiv positive subjects as compared to the healthy subjects . whereas fasting triglycerides and vldl were significantly higher in hiv positive cases compared to the hiv negative controls .
as the disease progresses with drop in cd4 count , there is a progressive decline in hdl , ldl , and total cholesterol levels and a rise in triglycerides and vldl levels of hiv positive subjects .
all the 45 hiv positive cases in our study were assessed for cimt by ultrasonography .
percentage of cimt > 8 mm , 8 mm , 7 mm , 6 mm and < 6 mm among the hiv positive population was found to be 0% , 33.33% , 15.55% , 51.11% and 0% as compared to 0% , 20% , 42.22% , 35.55% and 2% in the hiv negative population respectively .
there was no significant difference in cimt between the hiv positive cases and the hiv negative controls with a p = 1.00 .
in previous studies , right and left cimt were significantly higher in hiv positive groups as compared to the hiv negative controls . significant predictors of cimt measurements in uninfected controls were body mass index and homocysteine , but only the duration of art therapy was predictive of cimt in the hiv infected group . out of the 45 cases in this study , 42 had vitamin d deficiency and their mean cimt was 0.65 mm compared to the 33 out of the 45 healthy controls who are vitamin d deficient with mean cimt = 0.68 mm .
there was no significant difference between the two groups , which was contrary to findings of previous studies where the relationship between vitamin d insufficiency and increased cimt in hiv positive patients remained significant even after adjustment for traditional risk factors for hardening of the arteries , hiv related factors like viral load and duration of antiretroviral therapy and lipid levels .
vitamin d deficiency was significantly higher in hiv patients as compared to age and sex matched healthy controls and hence such patients would benefit from vitamin d supplementation given at initiation of art as it would offer a safe and effective means of augmenting the immune restoration response to treatment .
it can also be concluded that lipid profile may be a good index of disease progression in hiv patients .
 background : people with hiv are living decades longer than before due to combination art ; however , complications including cvd < osteoporosis and non aids defining malignancies are higher than in the general population . 
 many of the emerging complications related to chronic hiv infection represent disease processes where vitamin d is known to play an important role.objectives:a single point cross sectional case control study was conducted in a tertiary care hospital to determine the prevalence of vitamin d deficiency and its association with carotid intima media thickness ( cimt ) in hiv patients and to study the association of lipid profile with hiv infection . out of the 45 hiv positive cases , 
 vitamin d deficiency was found in 42 cases ( 93.33% ) whereas only 33 out of 45 ( 73.33% ) healthy controls . 
 fifty one point eleven percent of cases had dyslipidemia compared to 15.55% of controls . 
 a positive association was seen between cd4 levels and 25 hydroxy vitamin d. an inverse co - relation between cd4 count and triglycerides and vldl levels while a positive co - relation with total cholesterol , ldl cholesterol and hdl cholesterol levels was seen . 
 no significant difference was seen in cimt in cases and controls . 
Background:
Objectives:
I
A
M
R
D
C