Risk factors for vitamin D deficiency in HIV-1 infected adults in the South-Central United States
Presented by Rustin Crutchley (United States).
R. Crutchley1,2, J. Gathe Jr.2
1University of Houston, Houston, United States, 2Therapeutic Concepts, Inc., Houston, United States
Background: Few studies have evaluated risk factors for vitamin D deficiency in HIV-infected patients. We investigated the prevalence and risk factors for vitamin D deficiency in HIV-infected patients.
Methods: Cross-sectional study, October 2008 to April 2009, included 200 HIV-1 infected patients from a private practice in Houston, Texas (latitude 29 N, 43 minutes). Use of vitamin D supplements, dietary vitamin D intake, and average sunlight exposure (minutes/day) were surveyed for each patient. Pertinent laboratory values, demographics, body mass index (BMI), smoking status, and current antiretrovirals were also collected. Univariate and multivariate analyses were conducted to assess risk factors for vitamin D deficiency.
Results: 200 patients aged 45 ± 9.8 (mean ± SD) were evaluated in this study. Male 76%, 49% African American, 40% Caucasian, and 9% Hispanic. Median (range): BMI 26.2 (23.3, 29.7), CD4 388 (217, 610) cells/mm3, CD4% 22.2 (14.7, 30.4). 82% had viral load < 400 copies/mL. Among 87% patients on antiretrovirals, 67% were receiving protease inhibitors and 20% non-nucleoside reverse transcriptase inhibitors. Median serum 25(OH)D was 15.5 (10.9, 24.6). Vitamin D levels were commonly suboptimal (< 30 ng/mL; 86%), deficient (< 20 ng/mL; 64%), or severely deficient (≤ 10 ng/mL; 20.5%). Univariate analysis revealed that African American, increased BMI, current smoker, minimal vitamin D supplement use, and low total daily vitamin D intake (supplement and dietary) were associated with vitamin D deficiency or worse (p< 0.05, each). In multivariate analysis, African American race (Adjusted Odds Ratio (AOR):3.53; 95% CI: 1.83-6.82; p=0.0002)), BMI (AOR: 1.069 95% CI: 1.002-1.139; p=0.043), and no vitamin D supplementation (AOR: 0.997 95% CI: 0.996-0.999; p=0.0002) were significant independent predictors of vitamin D deficiency or worse.
Conclusions: Vitamin D deficiency or severe deficiency was highly prevalent in this diverse HIV population. In the HIV population, African Americans or patients with high BMI may benefit from vitamin D supplementation.
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