Date of Conferral

2015

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Sriya Krishnamoorthy

Abstract

Vitamin D deficiency is common in individuals diagnosed with HIV and is known for its detrimental health effects. Its recognition as a potent immune-modulator with possible immune health implications in HIV disease progression was the main impetus for this study. The association between Vitamin D and CD4 count falls short of being consistent and is too weak to allow conclusions. Similarly, the literature is inconsistent with regard to the impact of Vitamin D supplementation on CD4. This observational, retrospective chart review study aimed to explore the relationship between Vitamin D deficiency and CD4 count/percent, and to evaluate whether changes in Vitamin D levels after supplementation corresponds with significant changes in CD4 count/percent in a cohort of African American, HIV-infected men who attended an HIV clinic in southeast Michigan (N = 70). The conceptual framework was based on the role of Vitamin D in regulating the immune responses through Vitamin D nuclear receptors on the CD4 cells. It postulated that an increase in Vitamin D level might enhance immune function, promote cellular anti-inflammatory state, and decelerate CD4 destruction. Data analysis included descriptive statistics, bivariate correlation, logistic and linear regression, t test, repeated measures ANOVA, and ANCOVA. Findings of the study did not support the hypotheses of significant correlation between Vitamin D and CD4 count (p = 0.458) and percent (p = 0.776), or of any impact of supplementation on CD4 count (p = 0.216) and percent (p = 0.918). Social change implications include providing health professionals, researchers, and policymakers with knowledge to tailor health promotion interventions aiming to reduce Vitamin D deficiency in favor of improving the overall health of HIV patients, especially high-risk groups such as African American HIV-infected patients.

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