Oleh Hasna Afifah (email@example.com), Randy Satria Nugraha (firstname.lastname@example.org) – 2010
The cases of TB associated HIV in the world have become the cause of increasing morbidity people in the world per year, especially in the tropical area, like Indonesia. The resistance of the anti-tuberculosis drugs which often occurs in HIV-infected person has become a problem which needs a new strategy to help the prime therapy to minimize the complications such as adjuvant therapy. Vitamin D has been known well by having an immunomodulation function, so it has potency to become adjuvant therapy. The reviews which are related with the effect of vitamin D from preclinical and clinical trial haven’t been done yet, that is why the relation is necessary to be known. In making this paper, the writers use the literature method to compare the associated trials, especially in year 2004-2011.
Cathelicidin can trigger autophagy as a response from VDR (Vitamin D Receptor). Autophagy has a potency to eradicate M.tuberculosis and HIV. The newest clinical trial shows that intervention of vitamin D to TB-infected and TB-HIV infected person can accelerate culture sputum conversion, but only in person who has genotype tt of VDR TaqI. This finding demonstrates the potential dose of vitamin D as adjuvant therapy for TB associated HIV-1.
The main conclusions of this review are (1) metabolite of vitamin D can trigger autophagy against M.tuberculosis and HIV-1 which is mediated by VDR, (2) the adjuvant theraupic dose which can be used is ≥ 2000-100000 IU (depends on serum vitamin D status an defficiency risk factors). We hope that vitamin D can be applied as adjuvant therapy and the basic immunotherapy development for coinfection TB-HIV, MDR-TB, and XDR-TB.
Keywords: Autophagy, Cathelicidin, HIV, TB, Vitamin D