Vitamin D Deficiency in HIV-Infected Women on Antiretroviral Therapy Living in the Tropics

Abstract

The effects of HIV/AIDS and antiretroviral drugs on vitamin D metabolism are still mostly unknown. This was a cross-sectional study to estimate the prevalence of vitamin D deficiency and identify its association with the clinical and metabolic parameters among 214 HIV-positive female patients on antiretroviral therapy (ART) in Brazil. The prevalence of vitamin D deficiency (< 30 ng/ml) was 40.65% (87/214). Hypercholesterolemia, high LDL-c, duration of use of current antiretroviral regimen, hypertriglyceridemia, body mass index, age, hypertension, time with AIDS ≥ 10 years and hyperglycemia were selected for multivariate analysis (p < 0.20). After this analysis, hypercholesterolemia and use of current antiretroviral regimen ≥ 3 years remained independently associated with vitamin D deficiency. There was an inverse statistically significant correlation between total cholesterol and serum 25(OH)D levels. High prevalence of vitamin D deficiency was found among HIV-positive women on ART and was independently associated with its prolonged use and with hypercholesterolemia.

Vitamin D and diabetes mellitus: an update 2013

“…Vitamin D deficiency has been reported to be higher in various age groups of HIVinfected individuals, ranging from 60% of adolescents and young adults with serum 25(OH)D levels of less than 10 ng/mL in the Netherlands (32) (40° N) to more than 80% of adults, with a mean age of 41 years, showing serum 25(OH)D levels of less than 18 ng/ mL in Italy (30° N). In a group of premenopausal HIV women with a mean age of 40 years living in the city of Recife (10° S), 60% of them with lipodystrophy, 80% with dyslipidemia and 38% with metabolic syndrome, we found a 41% prevalence of vitamin D deficiency using a cut point of 30 ng/mL for serum 25(OH)D. After full adjustments, total serum cholesterol levels and the duration of ART were independently associated with vitamin D deficiency (33).…”

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

“…The two articles that reported the lowest frequency of vitamin D deficiency or insufficiency were undertaken in Brazil and Tanzania. 8,41 Considering the countries where the other trials were performed, no clear trend in the prevalence of hypovitaminosis D was found, with studies performed in similar populations within the same country (eg, France, Italy) reporting quite different results. 10,28,32,50 We observed similar inconsistencies while exploring the overall frequencies of hypovitaminosis D taking into account the use of vitamin D supplements.…”

“…27,31,41 Considering other HIV-related risk factors, patchy correlations were found between HIV viral load, duration of ART, duration of HIV, plasma neopterin, or soluble tumor necrosis factor-alpha receptor I and vitamin D deficiency. 6,8,9,23,25,28,37,52,54,57 Adverse health outcomes related to vitamin D deficiency in HIV-infected patients Very few studies investigated the detrimental effects of vitamin D deficiency on health outcomes other than bone diseases in HIV+. They were primarily cross-sectional correlation analyses, and it was therefore not possible to establish a cause-effect relationship.…”

“…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…”

“…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.…”