Short Communication: Early Changes in Parathyroid Hormone Concentrations in HIV-Infected Patients Initiating Antiretroviral Therapy with Tenofovir

Masiá, Mar; Padilla, Sergio; Robledano, Catalina; López-Riquelme, Natividad; Ramos, José Manuel; Gutiérrez, Félix

doi:10.1089/aid.2011.0052

Cited by 65 publications

(63 citation statements)

References 11 publications

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“…It is not self-evident, though, that these results can be transferred to HIV-infected subjects: for patients on anticonvulsant drugs (which are considered to interfere similarly to ART [1]) and patients with hyperparathyroidism (which was found to occur secondary to ART with tenofovir disoproxil fumarate [5,6]) a loss of seasonality has been described [7,8]. Although a seasonal difference has been hinted at in some small or highly selective HIV-infected populations [9][10][11][12], detailed information is sparse.…”

Section: Seasonal Variations In Vitamin D Levels In Hiv-infected Patimentioning

confidence: 99%

Seasonal variations in vitamin D levels in HIV-infected patients

Noe¹,

Heldwein²,

Pascucci³

et al. 2017

HIV & AIDS Review

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Introduction: Human immunodeficiency virus (HIV)-infected patients treated with antiretroviral therapy (ART) are at high risk for vitamin D insufficiency, which is essentially caused by interference of medication with vitamin D metabolism. Under these conditions, the preservation of natural seasonal variability in vitamin D concentrations is not self-evident. Yet, for proper screening and interpretation of laboratory findings, knowledge about seasonality is essential. Aim of the study was to describe seasonal behavior in ART-treated HIV-infected patients in Central Europe. Material and methods:It was a retrospective single-center study. Patients' medical records were screened for serum vitamin D levels, β-crosslaps, and surrogate values of bone turnover.Results: A total of 1011 datasets (625 patients) were evaluated. Overall, the median vitamin D level was 19.6 µg/l. In 207 (16.4%) datasets, patients were receiving oral cholecalciferol supplementation. Seasonal changes in serum vitamin D levels were reflected by minimum levels (median 13.5 µg/l) in March and maximum levels (median 23.7 µg/l) in July (p < 0.001). In contrast, serum calcium levels were lowest in September and October (2.23 mmol/l) and highest in May (2.32 mmol/l). Conclusions:Significant variation in seasonal serum vitamin D levels was found in an unselected population of HIV-infected patients. This finding is in line with results from HIV-negative populations. Accordingly, the time point of vitamin D testing might be crucial for appropriate diagnosis of hypovitaminosis. We recommend vitamin D testing between December and May to provide the highest sensitivity. As serum calcium levels did not demonstrate the same pattern, the meaning of this finding is unclear and warrants further investigation.

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Section: Seasonal Variations In Vitamin D Levels In Hiv-infected Patimentioning

confidence: 99%

Seasonal variations in vitamin D levels in HIV-infected patients

Noe¹,

Heldwein²,

Pascucci³

et al. 2017

HIV & AIDS Review

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“…Of the remaining (43 papers), 30 articles reported original data with the pre-specified 25OHD cut-off values and were included in the review (Table 1). 6,[8][9][10]60 One study describing the prevalence of vitamin D deficiency in a subgroup of 21 patients with hypocalcemia and ten articles reporting 25OHD status with different cut-off levels were considered only to retrieve information about predictors of vitamin D status, 7,[48][49][50][51][52][53][54][55][56][57] and two duplicate publications were reviewed for additional data not presented in the original study. 42,58,59 Studies' characteristics…”

Section: Literature Searchmentioning

confidence: 99%

“…9,24,29,31,38 Similar but less consistent findings were observed for some nucleoside reverse transcriptase inhibitor (NRTIs), such as emtricitabine, tenofovir, and zidovudine. 7,29 Results for protease inhibitors (PIs) suggested a protective effect against hypovitaminosis D.…”

Section: Vitamin D Deficiencymentioning

confidence: 99%

“…7,8,36,[39][40][41][42][43][44][45]47,48,50,51 None of these was a casecontrol study comparing the frequency of this condition between HIV+ and healthy controls. The reported frequency of sHPTH at baseline varied from 0% to 33%.…”

Section: Secondary Hyperparathyroidism and Parathyroid Hormone Statusmentioning

confidence: 99%

“…1 In this context, several cross-sectional and prospective studies have shown a high prevalence of vitamin D abnormalities in HIV+ subjects. [6][7][8][9][10] The high frequency of vitamin D deficiency in this population has raised great interest, not only because of the potential implications for bone health, but also because of the detrimental effects of vitamin D deficiency on multiple health outcomes.…”

Section: Introductionmentioning

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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Treatment of Human Immunodeficiency Virus Infection With Tenofovir Disoproxil Fumarate–Containing Antiretrovirals Maintains Low Bone Formation Rate, But Increases Osteoid Volume on Bone Histomorphometry

Ramalho

Martins

Galvão

et al. 2019

Journal of Bone and Mineral Research

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Bone mineral density (BMD) loss is a known complication of human immunodeficiency virus (HIV) infection and its treatment, particularly with tenofovir disoproxil fumarate (TDF)‐containing antiretroviral regimens. Although renal proximal tubular dysfunction and phosphaturia is common with TDF, it is unknown whether BMD loss results from inadequate mineralization. We evaluated change in BMD by dual‐energy X‐ray absorptiometry (DXA) and bone histomorphometry by tetracycline double‐labeled transiliac crest biopsies in young men living with HIV before (n = 20) and 12 months after (n = 16) initiating TDF/lamivudine/efavirenz. We examined relationships between calciotropic hormones, urinary phosphate excretion, pro‐inflammatory and pro‐resorptive cytokines, and bone remodeling‐related proteins with changes in BMD and histomorphometry. Mean age was 29.6 ± 5.5 years, with mean CD4 + T cell count of 473 ± 196 cells/mm3. At baseline, decreased bone formation rate and increased mineralization lag time were identified in 16 (80%) and 12 (60%) patients, respectively. After 12 months, we detected a 2% to 3% decrease in lumbar spine and hip BMD by DXA. By histomorphometry, we observed no change in bone volume/total volume (BV/TV) and trabecular parameters, but rather, increases in cortical thickness, osteoid volume, and osteoblast and osteoclast surfaces. We did not observe significant worsening of renal phosphate excretion or mineralization parameters. Increases in PTH correlated with decreased BMD but not histomorphometric parameters. Overall, these data suggest abnormalities in bone formation and mineralization occur with HIV infection and are evident at early stages. With TDF‐containing antiretroviral therapy (ART), there is an increase in bone remodeling, reflected by increased osteoblast and osteoclast surfaces, but a persistence in mineralization defect, resulting in increased osteoid volume. © 2019 American Society for Bone and Mineral Research.

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Short Communication: Early Changes in Parathyroid Hormone Concentrations in HIV-Infected Patients Initiating Antiretroviral Therapy with Tenofovir

Cited by 65 publications

References 11 publications

Seasonal variations in vitamin D levels in HIV-infected patients

Seasonal variations in vitamin D levels in HIV-infected patients

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

Treatment of Human Immunodeficiency Virus Infection With Tenofovir Disoproxil Fumarate–Containing Antiretrovirals Maintains Low Bone Formation Rate, But Increases Osteoid Volume on Bone Histomorphometry

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