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Vitamin D deficiency not associated with HIV clinical outcomes
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Vitamin D deficiency was not correlated with lower bone mineral density in black patients with HIV, according to recent data.
“Low bone mineral density is seen in a generally healthy HIV population, especially in those of black ethnicity,” Naomi Aronson, MD, professor of medicine and director of the infectious diseases division of the Uniformed Services University of Health Sciences, said. “Vitamin D deficiency was not found to be a risk factor in our HIV cohort for bone loss, but less exercise, black ethnicity, increased ethanol usage, family history of osteoporosis were associated with low BMD in our study.”
Aronson, and other colleagues led by Jeff Sherwood, MD, of the William Beaumont Army Medical Center, conducted the study in 205 active duty military beneficiaries with HIV, of whom 165 had two matched controls without HIV. The participants had undergone DEXA screening in 2001-2002. Vitamin D levels were evaluated from stored serum taken at the time of the DEXA scan and 6 to 18 months prior.
Jeff Sherwood
Those with HIV were more likely to have vitamin D deficiency than the controls, but this was not significant (OR=1.46; 95% CI, 0.87-2.45). Black people were disproportionately affected, but this was not related to HIV status or low BMD. The researchers could not determine a relationship between tenofovir exposure and vitamin D deficiency or low BMD based on the available data. There also were no significant associations between vitamin D levels and antiretroviral therapy (ART) exposure, HIV progression, hospitalizations and death.
“Data suggest that patients with HIV should have BMD testing done regardless of age,” Aronson said. “If low BMD is identified, interventions such as increased exercise, decreased alcohol use and dietary calcium intake alternative to dairy products should be pursued.”
Aronson said that it is unclear if normalizing vitamin D levels will have any long-time benefit to patients with HIV. The practice of treating HIV with vitamin D supplements to improve outcomes is not supported by this study and should be subjected to larger clinical trials before widely implemented, she said.
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