%0 Journal Article
%T Vitamin D deficiency in a cohort of HIV-infected patients: clinical analysis
%A D Wilmes
%A P Forget
%A A Vincent
%A L Belkhir
%J Journal of the International AIDS Society
%D 2012
%I 
%R 10.7448/ias.15.6.18205
%X Purpose of the study: Observational studies have noted very high rates of low serum 25-hydroxyvitamin D [25(OH)D3] levels in both general and HIV-infected populations. In HIV-infected patients, low 25(OH)D3 levels are secondary to a combination of usual risk factors and HIV-specific risk factors, like antiretroviral therapy [1]. The objective of our study is to analyse the magnitude of vitamin D deficiency or insufficiency and the role of various factors such as age, sex, ethnicity, season, and antiretroviral medications in our cohort of HIV-infected patients. Methods: We prospectively collected data on 25-hydroxyvitamin D levels sampled between January 2009 and June 2011 from our cohort of 930 HIV-infected patients. Vitamin D dosage was performed using immunoassay (¡®Diasorin¡¯ - Saluggia, Italy). We divided vitamin D levels into 3 categories: 25-hydroxyvitamin D levels <20 mg/nl were considered deficient, insufficient between 20 and 29 ng/ml. Levels ¡İ30 ng/ml were defined as normal [2]. Data on demographic features (age, ethnicity, season, heterosexuality vs homosexuality), clinical features and laboratory findings (CD4 cell count, viral load, HAART, BMI) were collected from patients¡¯ medical records using our institutional database ¡®Medical explorer v3r9, 2009¡¯. Summary of results: Overall, 848 patients were included in our study (Table 1). Low levels of serum 25(OH)D3 were seen in 89.3% of the study population, from which 69.5% were deficient and 19.8% were insufficient. On univariate analysis, female sex, high BMI, black African, heterosexuality, undetectable viral load and antiretroviral treatment were all predictors of vitamin D deficiency and insufficiency. Treatment with efavirenz and tenofovir were the most associated with low vitamin D levels. On multivariate analysis (multiple linear regression model) only female sex (OR=1.14; 95% CI 0.84¨C0.96; p<0.001), dosage during winter months (OR=1.14; 95% CI 1¨C1.15; p<0.05) and HAART (OR=1.12; 95% CI 1.04¨C1.19; p=0.002) were identified as independent risk factors of low 25(OH)D3 levels. Conclusion: Vitamin D deficiency is frequent in HIV-infected populations (69.5%). Patients on antiretroviral therapy are at higher risk of vitamin D deficiency. In our cohort, black women and dosage during winter were also independent risk factors for low vitamin D levels.
%U http://www.jiasociety.org/index.php/jias/article/view/18205/2251