Validation Protocol of Vitamin D Supplementation in Patients with HIV-Infection

• Published in: AIDS Research and Treatment Vol. 2016; no. 2016; pp. 156 - 163
• Main Authors: Lerma-Chippirraz, Elisabet, Güerri-Fernández, Roberto, Villar García, Judit, González Mena, Alicia, Guelar Grinberg, Ana, Montero, María Milagro, Sorli, Luisa, Calzado, Sonia, Horcajada, Juan Pablo, Díez-Pérez, Adolfo, Knobel Freud, Hernando
• Format: Journal Article
• Language: English
• Published: Cairo, Egypt Hindawi Limiteds 01-01-2016; Hindawi Publishing Corporation; John Wiley & Sons, Inc; Hindawi Limited
• Subjects: Alfacalcidol; Calcifediol; Care and treatment; Dosage and administration; Food and nutrition; Highly active antiretroviral therapy; HIV patients; Methods; Vitamin D; Spain
• ISSN: 2090-1240; 2090-1259
• DOI: 10.1155/2016/5120831

Hypovitaminosis D and secondary hyperparathyroidism are frequent among HIV-infected patients. As there are no data about the best supplementation therapy both in treatment and in maintenance, we conducted an observational study of 300 HIV-infected patients for whom vitamin D and parathormone (PTH) had been measured in order to validate a protocol of vitamin D supplementation in patients with HIV-infection. Patients with vitamin D deficiency (defined as 25(OH)D < 10 ng/mL), insufficiency (defined as 25(OH)D < 20 ng/mL), or hyperparathyroidism (PTH > 65 pg/mL) were supplemented with cholecalciferol 16.000IU (0.266 mg) weekly (if deficiency) or fortnightly (if insufficiency or high PTH levels). Rates of normalization of 25(OH)D (levels above 20 ng/mL) and PTH levels (<65 pg/mL) were analyzed. Multivariate analysis of factors related to normalization was carried out. With a median follow-up of 2 years, 82.1% of patients with deficiency and 83.9% of cases with insufficiency reached levels above 20 ng/mL. However, only 67.2% of individuals with hyperparathyroidism at baseline reached target levels (<65 pg/mL). Independent factors for not achieving PTH objective were tenofovir (TDF) and protease inhibitors use. In HIV-infected patients with hypovitaminosis, the protocol of cholecalciferol supplementation normalized vitamin D levels regardless of antiretroviral regimen in a high proportion of patients but it was less effective to correct hyperparathyroidism.