XVIII International AIDS Conference

Abstract

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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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