Document 0679
 DOCN  M9480679
 TI    [The relationship between tuberculosis, vitamin D, potassium and AIDS. A
       message for South Africa?]
 DT    9410
 AU    Lochner JD; Schneider DJ; Departement Geneeskundige Fisiologie en
       Biochemie, Universiteit; van Stellenbosch, Tygerberg.
 SO    S Afr Med J. 1994 Feb;84(2):79-82. Unique Identifier : AIDSLINE
       MED/94317066
 AB    The converging epidemics of tuberculosis and acquired immunodeficiency
       syndrome (AIDS) in the RSA and their expected catastrophic interaction
       afford an ideal opportunity for well-planned and essential research by
       clinicians, molecular biologists, epidemiologists and other health
       workers. The enigmatic relationship between tuberculosis, vitamin D and
       calcium is a field of study which should be considered urgently. An
       optimal vitamin D status not only assures sound calcium-phosphorus
       homeostasis, but is also essential for maximal immune competency.
       Hypovitaminosis D probably predisposes towards vulnerability to
       tuberculosis due to deficient monocyte-macrophage function. In contrast,
       hypervitaminosis D can correct this deficiency, but would do so at the
       cost of both B- and T-lymphocyte efficiency. One example of such a state
       is the endogenous over-production of activated vitamin D by
       gamma-interferon-activated monocytes, tissue macrophages and
       granulomatous tissue in tuberculosis. This would not only cause the
       coincidental hypercalcaemia, but may also complicate the effective
       co-ordination of monocyte-lymphocyte interaction and consequently
       compromise an appropriate immune response. It can reasonably be expected
       that the raised plasma interferon levels in the AIDS patient may trigger
       similar vitamin D-related pathophysiological processes. It is proposed
       that the ideal situation for enhanced vulnerability to tuberculosis in
       the AIDS patient will have been created if the known destructive effects
       of the human immunodeficiency virus on CD4-positive lymphocytes act
       synergistically with the vitamin D-mediated complications listed above.
 DE    *Acquired Immunodeficiency Syndrome/DRUG THERAPY/EPIDEMIOLOGY  English
       Abstract  Human  *Potassium/PHARMACOLOGY/THERAPEUTIC USE  South
       Africa/EPIDEMIOLOGY  *Tuberculosis/DRUG THERAPY/EPIDEMIOLOGY  *Vitamin
       D/PHARMACOLOGY/THERAPEUTIC USE  JOURNAL ARTICLE

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