Prevalence of vitamin D deficiency in human immunodeficiency virus-infected patients

Purpose of the study: Vitamin D deficiency in the adults could produce osteomalacia, secondary hyperparathyroidism with bone loss and increased risk of fractures. An increased prevalence of osteopenia, osteoporosis, decreased bone density, vitamin D deficiency and increased risk of fracture was found in HIV-positive patients. A study performed in Buenos Aires, Argentina that included non-HIV-infected adult patients showed 15% prevalence of vitamin D deficiency in winter and 0% prevalence in summer. There is no local data published of vitamin D deficiency in HIV-positive populations. The aim of the study is to determinate the prevalence of vitamin deficiency in our HIV-positive population receiving HAART. Methods: An observational, retrospective study was performed. We reviewed the clinical charts of the HIV-positive adult patients attending the infectious disease clinic. We collected data of vitamin D, parathormone and beta cross laps value; we recorded if the test was performed in winter or summer. We considered vitamin D deficiency if<10 ng/ml. We recorded age, sex, comorbidities (diabetes mellitus, renal failure, hepatic failure, HBV and/or HCV coinfection, menopause, malignancy and metabolic syndrome), months since HIV diagnosis, CD4 count, viral load and HAART. Summary of results: 60 patients were included, 49 (65%) of whom were male. Mean age was 49.15 years. Mean time from diagnosis was 112 months. Mean CD4 count was 548 cells/mm3 and 6.6% presented CD4 <200; 83.3% had viral load <50 copies/mm3. All patients were on HAART; 50% received efavirenz, 65% received tenofovir and 11.6% recived atazanavir. Mean vitamin D value was 23.58 ng/ml (5–66.5 ng/ml). In winter, 15.3% of the patients had <10 ng/ml of vitamin D and mean value was 24.16 ng/ml (10–40 ng/ml). Although the mean value in summer was 25.8 ng/ml (11.6–66 ng/ml) 10% of the patients had vitamin D deficiency. PTH value was abnormal in 31.6% of patients and beta cross laps was abnormal in 10% of patients. Conclusions: Although the small number of patient included, we observed a high prevalence of vitamin D deficiency even in summer. A systematic assessment of vitamin D must be included in HIV positive patient care.