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Evaluation of vitamin D levels in HIV-infected patients at the Center of Comprehensive Care, St Luke´s Roosevelt Hospital Center, New York, USA
Presented by Vani Gandhi (United States).
V. Gandhi1, J.H. Kim2, G. Psevdos Jr.1, F. Espinoza3, J. Park4, V. Sharp4
1Center for Comprehensive Care, St Luke's Roosevelt Hospital, Infectious Diseases, New York, United States, 2University of Pittsburgh Medical Center, Infectious Diseases, Pittsburgh, United States, 3St Luke's Roosevelt Hospital, Medicine, New York, United States, 4Center for Comprehensive Care, St Luke's Roosevelt Hospital, New York, United States
Background: Vitamin D (VitD) regulates bone metabolism but has also
immunoregulatory properties. Osteopenia
and osteoporosis are increasingly observed in HIV-infected patients. Few studies have examined the VitD status in
HIV-infected patients.
Methods: A retrospective chart review of 2992 HIV-infected patients was
conducted from 9/1/08 to 5/31/09. 342
patients had 25-hydroxyvitamin D obtained by radioimmunoassay (ARUP® Laboratories,
Salt Lake City, UT, USA).
None were receiving VitD supplements.
Level < 20ng/mL denotes deficiency, 21-29 insufficiency, 30-80 optimum
levels. We analyzed demographic/laboratory
data and risk factors for VitD deficiency.
Results: VitD deficiency was noted in 205/342 59.9%; Insufficiency
in 86/342, 25.1% and 51/342, 14.9% had levels between 30-66. The characteristics of the 342
patients: 73% men, 43.5% African American, 30.4% Hispanic, 23.3% Caucasian,
1.16% Asian; HIV risk factors: 47.5% MSM, 26.3% IDU, 35.3% Heterosexual; mean
age: 47.2; mean CD4: 444/µL, mean HIV
viral load log10 4.09, mean albumin 4.4mg/dL, mean calcium: 9.3mg/dL. 81% were receiving antiretrovirals. 78% of VitD measurements occurred from
December to March. Comparing the
deficient and insufficient group (291 patients) with the normal (51 patients),
there were no differences in age (P:
0.386), sex (P: 0.550), Caucasian or
Hispanic race, CD4 (P: 0.255), HIV
viral load (P: 0.277), exposure to
tenofovir (P: 0.831), albumin (P:0.846), and body mass index (BMI) (P: 0.155). There was a difference,
however, in African American race (P:0.027),
and calcium levels (P:0.011). A logistic regression analysis for predictors
of VitD level < 20 found African American Race (OR: 2.615 95% CI:1.404 -
4.871), calcium level < 8.5 (OR: 14.580
95% CI: 1.464 - 145.184) and BMI ≥ 18.5 (OR: 5.766 (1.236 - 26.904) to be
associated with VitD deficiency.
Conclusions: VitD deficiency was prevalent in our patients
during the months with decreased sun exposure in the Northeastern
United States.
African Americans were more likely to be VitD deficient
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