Hypovitaminosis D and Bone Mineral Density in Human Immunodeficiency Virus-Infected Men from India, with or without Antiretroviral Therapy

Paul, Thomas; Asha, Hesarghatta Shyamasunder; Nicolaï, Thomas; Seshadri, M. S.; Rupali, Priscilla; Abraham, Ooriapadickal Cherian; Pulimood, Susanne; Jose, Arun

doi:10.4158/ep09197.or

Cited by 27 publications

(28 citation statements)

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“…19 Other factors such as malnutrition and Vitamin D deficiency might also be causing these increased prevalence of osteoporosis. 20 Casado et al studied 285 subjects and found the prevalence of osteopenia in HIV population to the tune of 36% to 57% depending on the presence of secondary factors. 19 Present present study also found osteopenia in 50.4% of cases which is in the same range.…”

Section: Discussionmentioning

confidence: 99%

A study of bone mineral density among people living with HIV in India and its correlation with CD4 count

et al. 2017

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Background: Data on the prevalence of osteoporosis in HIV patients in Asian population is scarce this study was done to find out the prevalence of osteoporosis in HIV infected patients and its correlation with CD4 counts.Methods: This cross- sectional study was conducted in NACO- ART center of tertiary care hospital. Total 115 HIV patients were included in this study which were divided into ART naive (n= 69) and patients taking ART (n= 46). We analysed BMD by DEXA in 115 HIV positive patients and 78 HIV negative age and sex matched controls. Correlation of BMD with a CD4 count and ART regimen was studied.Results: BMD was found to be low in HIV positive patients. T score in HIV positive patients was significantly lower (p<0.05) as compared to the HIV negative control group. The prevalence of osteopenia and osteoporosis in HIV positive patients was 50.4% and 29.6% respectively, as compared to 23.1% and 2.6% in HIV negative controls. BMD showed relation with CD4 count. We did not find any statistical difference between any ART regimen and BMD.Conclusions: The prevalence of osteopenia and osteoporosis in HIV infected cases was higher as compared to HIV negative controls and higher in ART group as compared to ART naïve group. Low BMD levels show correlation with low CD4 count. We recommend that HIV positive patients especially with advanced stage of disease, low CD4 count should be screened for low BMD by DEXA scan for osteoporosis and managed accordingly

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Section: Discussionmentioning

confidence: 99%

A study of bone mineral density among people living with HIV in India and its correlation with CD4 count

et al. 2017

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“…Considering the main findings and studies undertaken in large populations, only some specif ic ART classes or agents were clearly found to be related to hypovitaminosis D. 9,10,23,24,26,[29][30][31][33][34][35]37,38,40,42,35 Several authors demonstrated that non-nucleoside reverse transcriptase inhibitor (NNRTI) use was associated with 25OHD deficiency. 10,35,37,40,45,51 For efavirenz, in particular, an association with low 25OHD concentration has often been suggested.…”

Section: Vitamin D Deficiencymentioning

confidence: 99%

“…The three matched case-control analyses 27 a significantly higher prevalence in healthy controls in another, 30 and a significantly higher prevalence in HIV-infected patients in the third. 34 The study with the higher prevalence in the control group was performed in African-American subjects, 30 who are usually regarded as being at high risk of hypovitaminosis D. 61 As a result, both cases and controls had a very high rate of hypovitaminosis D. Paul et al 34 found a 20% greater prevalence of 25OHD ,20 ng/mL in HIV-infected patients, but they enrolled a very small sample (70 cases and 35 controls).…”

Section: Vitamin D Deficiencymentioning

confidence: 99%

“…In three of them, controls were age-and sex-matched to HIV+ (also BMI-matched in one study, same race in another). 27,30,34 Stein et al and Yin et al recruited controls of identical gender (women) and menopausal status (post-and pre-menopausal, respectively) as the HIV cases. 42,60 In the remaining four articles, authors used unmatched controls, as follows: healthy subjects from the community or the clinic (n = 2), 23 uninfected at-risk subjects with the same gender (n = 1).…”

Section: Vitamin D Deficiencymentioning

confidence: 99%

“…Nine studies compared vitamin D status between HIV+ and "healthy" subjects, 9,23,25,27,30,31,34,42,60 but only three of them were matched case-control analyses. 27,30,34 Overall, the studies were heterogeneous in terms of demographic and clinical characteristics of populations included. Even the data collected and the methods used to report the information were quite variable (eg, age and duration of ART therapy were described as mean ± standard deviation, median with interquartile range, or range).…”

Section: Literature Searchmentioning

confidence: 99%

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Vitamin D deficiency in HIV-infected patients: a systematic review

Giusti¹,

Penco²,

Pioli³

2011

NDS

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Advances in the diagnosis and management of human immunodeficiency virus (HIV) have resulted in a dramatic decrease in mortality in HIV-infected individuals (HIV+). The subsequent increase in life expectancy of HIV+ has led to the need to consider the long-term complications of the disease and its treatment. Abnormalities in vitamin D status and metabolism are increasingly recognized as a major concern in HIV infection. In the last 5 years a number of cross-sectional and prospective studies have suggested a high prevalence of vitamin D deficiency in HIV+. Although few case-control studies have been published, it has been suggested that the prevalence of hypovitaminosis D in HIV+ is higher than in the general population, and at least in part, is related to the course of the disease and/or the antiretroviral drugs used to treat the disease. An adequate vitamin D status is important not only for bone tissue, but also for the global health status of HIV+ individuals, since a growing body of evidence has demonstrated the detrimental effects of vitamin D deficiency on multiple health outcomes. Therefore, definition of the size of the problem and identification of effective protocols for the prevention and management of vitamin D deficiency in HIV+ patients represent important steps in improving health status and reducing long-term chronic complications in individuals with HIV. Due to its immunomodulatory effects, vitamin D may also have implications in the progression of HIV infection. This systematic review was designed to determine the prevalence of vitamin D deficiency in HIV+ patients; to identify risk factors (related to the HIV infection or not) potentially associated with this condition; to describe the potential consequences of hypovitaminosis D on the course of the infection and the benefits of vitamin D repletion; and to make some suggestions about the future, considering the limitations of previous studies.

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People Living With HIV: Implications for Rehabilitation Nurses

Perazzo¹,

Webel²,

McGough³

et al. 2018

Rehabilitation Nursing

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Purpose To present a brief overview of challenges faced by people living with HIV (PLHIV) as they age, to discuss the relevance of HIV to rehab nurses, and to provide evidence-based recommendations for rehabilitation professionals working with PLHIV. Design Current Issues Article Methods Literature review related to age-related comorbidities in PLHIV with implications for rehabilitation nurses. Conclusions PLHIV experience higher rates of age-related comorbidities compared to the general population and will require rehabilitation expertise in their healthcare. Understanding unique characteristics of PLHIV as well as applying focused assessment and tailored interventions in PLHIV will give rehabilitation nurses the tools to successfully guide PLHIV through the rehabilitation process and optimize clinical outcomes. Clinical Relevance As people with HIV age and experience acute and chronic comorbidities, they will require the clinical expertise of rehabilitation nurses in the process to successfully transition through acute and sub-acute healthcare and regain function.

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Hypovitaminosis D and Bone Mineral Density in Human Immunodeficiency Virus-Infected Men from India, with or without Antiretroviral Therapy

Cited by 27 publications

References 27 publications

A study of bone mineral density among people living with HIV in India and its correlation with CD4 count

A study of bone mineral density among people living with HIV in India and its correlation with CD4 count

Vitamin D deficiency in HIV-infected patients: a systematic review

People Living With HIV: Implications for Rehabilitation Nurses

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