High prevalence of vitamin D deficiency among HIV-infected patients
Presented by Catherine Chien (United States).
C. Chien, C. Carlotti, L. Bhatti, P. Jongthavorn, P. DenOuden, M. Valdes-Suerias, S. Sayana, H. Khanlou
AIDS Healthcare Foundation, Department of Medicine, Los Angeles, United States
Background: Vitamin-D supplementation has long been recommended in the promotion of healthy bone growth and remodeling. In recent years, vitamin-D deficiency has been linked to a wide variety of medical ailments, including cardiovascular disease, hypertension, chronic headaches, various cancers, and mood disorders. A link between vitamin-D deficiency and risk of infection was established more than a century ago with observations of higher rates of respiratory infections in children with nutritional rickets. In HIV-infected patients, this deficiency may have additional impact on immune function.
Methods: We evaluated the prevalence of vitamin-D deficiency in a cohort of HIV-infected patients in our Los Angeles clinics. Patients who had at least one 25-(OH)-vitamin-D measurement within the past 6-month period (06/01/09 - 12/31/09) were included in this analysis. A normal serum vitamin-D level was defined as > 30 ng/mL. Vitamin-D-insufficiency was defined as a concentration of 20-30 ng/mL, whereas vitamin-D-deficiency was defined as < 20 ng/mL.
Results: 465 patients were identified based on our search criteria. Mean age was 45 years old (range 19-73); 388 males (83%), 72 females (15%), 5 transgender (2%); 161 Caucasian (35%), 151 Hispanic (32%), 139 African-American (30%), 12 Asian-Pacific-Islander (3%), 2 Native-American (< 1%). Mean CD4 count was 520 cells/mm3 (range 8-2352); mean HIV-RNA-level was 9347 copies/mL (3.97 log 10) [range < 48-879,550; 1.68-5.94 log10]. Of these patients, inadequate vitamin-D levels were identified in 306 patients (66%) of whom 174 (38%) met criteria for vitamin-D insufficiency and 132 (28%) met criteria for vitamin-D-deficiency. 159 patients (34%) were found to have normal vitamin-D levels.
Conclusions: Two-thirds of HIV-infected patients screened were found to be insufficient or deficient in vitamin-D stores. Given the known association between vitamin D and other infectious processes, it seems reasonable to add vitamin-D measurement and supplementation to the routine management of HIV-infected patients. The impact of vitamin-D deficiency warrants further research.
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