Vitamin D for Treatment and Prevention of Infectious Diseases: A Systematic Review of Randomized Controlled Trials

Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia 30030, USA.
Endocrine Practice (Impact Factor: 2.81). 07/2009; 15(5):438-49. DOI: 10.4158/EP09101.ORR
Source: PubMed


To review the existing human controlled intervention studies of vitamin D as adjunctive therapy in settings of infection and provide recommendations for design and implementation of future studies in this field on the basis of the evidence reviewed.
We conducted a systematic review of randomized controlled clinical trials that studied vitamin D for treatment or prevention of infectious diseases in humans. Studies from 1948 through 2009 were identified through search terms in PubMed and Ovid MEDLINE.
Thirteen published controlled trials were identified by our search criteria. Ten trials were placebo controlled, and 9 of the 10 were conducted in a rigorous double-blind design. The selected clinical trials demonstrated substantial heterogeneity in baseline patient demographics, sample size, and vitamin D intervention strategies. Serious adverse events attributable to vitamin D supplementation were rare across all studies. On the basis of studies reviewed to date, the strongest evidence supports further research into adjunctive vitamin D therapy for tuberculosis, influenza, and viral upper respiratory tract illnesses. In the selected studies, certain aspects of study design are highlighted to help guide future clinical research in the field.
More rigorously designed clinical trials are needed for further evaluation of the relationship between vitamin D status and the immune response to infection as well as for delineation of necessary changes in clinical practice and medical care of patients with vitamin D deficiency in infectious disease settings.

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    • "An epidemiological study of influenza in the United States has shown that a drop in AH is a good predictor of epidemic onset (Shaman et al., 2010). Other climatic factors have been proposed as drivers of influenza epidemiology, such as the number of hours of sunshine (Hope-Simpson, 1981), mediated through the effect of Vitamin D synthesis on individuals' innate immune response to infection (Cannell et al., 2006; Liu et al., 2006; Yamshchikov et al., 2009). However, this hypothesis remains unproven (Shaman et al., 2011). "
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    08/2015; 13:65-73. DOI:10.1016/j.epidem.2015.06.002
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    • "Given the data collected from previous studies, one would expect that supplementation with vitamin D would lead to faster eradication of the disease. A recent systematic review of randomized-controlled trials [26] showed mixed results with regard to vitamin D supplementation, urging for more data to be collected before any definitive conclusion could be reasonably made. "
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    • "This downregulation of VDR could be reversed upon treatment with 5-azacytidine (AZA) suggesting that the decreased expression of VDR by HIV is, at least partially, caused by DNA methylation (Chandel et al., 2013). There is evidence for an inverse correlation between the vitamin D status and infections, however, many trials failed to show a protective effect of vitamin D (reviewed in Yamshchikov et al., 2009). Thus, reduced sensitivity to vitamin D metabolites due to, e.g., downregulation of VDR may account for inconclusive trials. "
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