Decrease of vitamin D concentration in patients with HIV infection on a Non Nucleoside Reverse Transcriptase Inhibitor containing regimen

A Conesa-Botella, E Florence, L Lynen, R Colebunders, J Menten, R Moreno-Reyes

    Research output: Contribution to journalA4: Article in journal not included in A1, A2 or A3

    Abstract

    BACKGROUND: Vitamin D is an important determinant of bone health and also plays a major role in the regulation of the immune system. Interestingly, vitamin D status before the start of highly active antiretroviral therapy (HAART) has been recently associated with HIV disease progression and overall mortality in HIV-positive pregnant women. We prospectively studied vitamin D status in HIV individuals on HAART in Belgium. We selected samples from HIV-positive adults starting HAART with a pre-HAART CD4 T-cell count >100 cells/mm3 followed up for at least 12 months without a treatment change. We compared 25-hydroxyvitamin D plasma [25-(OH)D] concentration in paired samples before and after 12 months of HAART. 25-(OH)D levels are presented using two different cut-offs: <20 ng/ml and <30 ng/ml. RESULTS: Vitamin D deficiency was common before HAART, the frequency of plasma 25-(OH)D concentrations below 20 ng/ml and 30 below ng/ml was 43.7% and 70.1% respectively. After 12 months on HAART, the frequency increased to 47.1% and 81.6%. HAART for 12 months was associated with a significant decrease of plasma 25-(OH)D concentration (p=0.001). Decreasing plasma 25-(OH)D concentration on HAART was associated in the multivariate model with NNRTI-based regimen (p=0.001) and lower body weight (p=0.008). Plasma 25-(OH)D concentrations decreased significantly in both nevirapine and efavirenz-containing regimens but not in PI-treated patients. CONCLUSIONS: Vitamin D deficiency is frequent in HIV-positive individuals and NNRTI therapy further decreases 25-(OH)D concentrations. Consequently, vitamin D status need to be checked regularly in all HIV-infected patients and vitamin D supplementation should be given when needed.
    Original languageEnglish
    JournalAIDS Research and Therapy
    Volume7
    Issue number40
    Pages (from-to)1-6
    Number of pages6
    ISSN1742-6405
    DOIs
    Publication statusPublished - 2010

    Keywords

    • B780-tropical-medicine
    • Viral diseases
    • HIV
    • AIDS
    • HAART
    • Antiretrovirals
    • Regimens
    • Non-nucleoside
    • Reverse transcriptase inhibitors
    • Vitamin D
    • Deficiency
    • Bone mineral density
    • CD4 lymphocyte count
    • Cohort studies
    • Nevirapine
    • Efavirenz
    • Cholesterol
    • Associations
    • Body weight
    • Belgium
    • Europe-West

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