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

Sci Rep. 2014 Dec 9:4:7371. doi: 10.1038/srep07371.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antibodies, Viral / blood
  • Antibodies, Viral / immunology
  • Comorbidity
  • Female
  • Herpes Zoster / blood*
  • Herpes Zoster / etiology*
  • Herpesvirus 3, Human / immunology*
  • Hormones / blood
  • Humans
  • Immunocompromised Host
  • Immunoglobulin G / blood
  • Immunoglobulin G / immunology
  • Immunoglobulin M / blood
  • Immunoglobulin M / immunology
  • Male
  • Middle Aged
  • Minerals / metabolism
  • Prospective Studies
  • Renal Dialysis / adverse effects*
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood*

Substances

  • Antibodies, Viral
  • Hormones
  • Immunoglobulin G
  • Immunoglobulin M
  • Minerals
  • Vitamin D
  • 1,25-dihydroxyvitamin D