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Healio

International AIDS Conference
July 10, 2013
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Antiretroviral therapy decreases 25-OH vitamin D levels in HIV/HBV coinfected patients

Patients coinfected with hepatitis B and HIV had lower serum levels of 25-hydroxyvitamin D and were more likely to be considered vitamin D deficient after initiating antiretroviral therapy in a study presented at the International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention in Kuala Lumpur, Malaysia.

In a prospective cohort study conducted in Bangkok, researchers evaluated 158 patients coinfected with HIV and HBV (mean age, 42 years; 33% female). Ninety-two percent of participants had received antiretroviral therapy (ART) containing tenofovir, with 96% of these patients on lamivudine, 65% on a non-nucleoside reverse transcriptase inhibitor and 35% on a boosted protease inhibitor for a median of 5 years. The cohort had a median CD4 count of 509 cells/mm3, and 89% had HIV RNA levels below 50 copies/mL.

Median levels of serum 25(OH)D decreased significantly after initiation of tenofovir-based therapy, from 24.8 ng/mL to 22.8 ng/mL (P<.001), and more patients were considered 25(OH)D-deficient, with levels below 30 ng/mL (72.2% of patients before therapy initiation vs. 84.2%; P=.004). Multivariate analysis indicated significant associations between vitamin D deficiency and female sex (adjusted OR=3.6; 95% CI, 1.2-11.1) and a longer duration of ART (aOR=2.6; IQR 1.1-6.4; P=.039). No association was observed between fibrosis stage and vitamin D levels.

“Although our cohort of HIV/HBV coinfected patients live in the tropics, there was a high prevalence of hypovitaminosis D, especially in female patients and with prolonged ART,” the researchers wrote. “Given HIV/HBV coinfection requires long-term HBV-active drugs, including tenofovir, that can also contribute to bone loss, routine vitamin D assessment and supplementation as necessary should be considered in all HIV/HBV coinfected patients.”

For more information:

Apornpong T. WEPE458: Decline in Serum 25-OH Vitamin D levels in HIV-Hepatitis B Virus (HBV) Coinfected Patients After Long-Term Antiretroviral Therapy. Presented at: IAS Conference on HIV Pathogenesis, Treatment and Prevention; June 30-July 03, 2013; Kuala Lumpur, Malaysia.