{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T01:15:40Z","timestamp":1780708540514,"version":"3.54.1"},"reference-count":53,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T00:00:00Z","timestamp":1624492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NIH Research Training Grant; The Fogarty International Center, the NIH Office of the Director Office of AIDS Research & the NIH Office of the Director Office of Research on Women\u2019s Health.","award":["# D43 TW009345"],"award-info":[{"award-number":["# D43 TW009345"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>A high prevalence of suboptimal serum vitamin D has been reported among HIV infected children even in countries with high sunshine abundance throughout the year. Vitamin D is a potent immune modulator of innate and adaptive immune responses. Vitamin D regulates immune responses through the vitamin D receptor on CD4 cells. We aimed to determine the vitamin D status of HIV infected children and factors associated with suboptimal vitamin D.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This was a cross sectional study. We enrolled children aged between 6 months and 12 years attending an outpatient paediatric HIV clinic. Serum 25-hydroxyvitamin D (25(OH)D) was measured using the electrochemoluminisence method. Suboptimal vitamin D was defined as 25(OH)D &lt;30 ng\/ml, vitamin D insufficiency and deficiency were 21\u201329 ng\/ml and &lt;20 ng\/ml respectively. Anthropometry, physical exam and medical history were documented. Logistic regression was performed.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>We enrolled 376 children with mean age (sd) 8.05 years (3.03), a median (IQR) duration of ART of 5.9 years (3.2\u20138.4). Majority of the children (64%) had been exposed to non nucleoside reverse transcriptase inhibitors (NNRTIs). A third were severely immunosuppressed (CD4% \u226415%) at ART initiation. At the time of the study, the majority (89%) were virologically suppressed (VL &lt;1000 copies\/ml). Prevalence of 25(OH)D &lt;30 ng\/ml was 49 (13%) of 375 participants and 11 (3%) had 25(OH)D &lt;20 ng\/ml. Lopinavir\/ritonavir regimen was independently associated with 25(OH)D &lt;30 ng\/ml; OR 0.27 CI (0.13\u20130.57), p value-0.002. Serum 25(OH)D &lt;20 ng\/ml was associated with CD4 count \u226415% at ART initiation OR 6.55(1.30\u201332.9), p value\u20140.023 and use of NNRTIs; OR 10.9(1.22\u201396.2), p value\u20140.03.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>We found a low prevalence of suboptimal vitamin D compared to earlier reports. Severe immunosuppression at ART initiation and use of NNRTIs increases odds of deficiency. Vitamin D supplementation should be considered in severely immunosuppressed children initiating ART.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0253689","type":"journal-article","created":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T17:36:33Z","timestamp":1624556193000},"page":"e0253689","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":15,"title":["Vitamin D status and associated factors among HIV-infected children and adolescents on antiretroviral therapy in Kampala, Uganda"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9818-093X","authenticated-orcid":true,"given":"Thereza Were","family":"Piloya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Bakeera\u2013Kitaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace Paul","family":"Kisitu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Idro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah E.","family":"Cusick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,6,24]]},"reference":[{"key":"pone.0253689.ref001","unstructured":"Joint United Nations Programme on HIV\/AIDS. 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