Risk Factors of Hypovitaminosis D in HIV-Infected Patients on Suppressive Antiretroviral Therapy

AIDS Res Hum Retroviruses. 2020 Aug;36(8):676-680. doi: 10.1089/AID.2019.0020. Epub 2020 Jun 8.

Abstract

Low serum vitamin D levels are very common in human immunodeficiency virus (HIV)-infected patients. In our cross-sectional study, we investigated the association between 25-hydroxyvitamin D (25(OH)D) levels and serum inflammation markers [C-reactive protein (CRP), white blood cells (WBC), D-dimers, platelet count (PLT)] in 148 HIV-infected patients on combined antiretroviral therapy [28 on tenofovir alafenamide (TAF)] and 40 healthy controls. The controls were significantly older (56.6 ± 19.1 years for HIV(-) vs. 45.1 ± 11.8 years for HIV(+); p = .001) and more females were observed in this group (65% for HIV(-) vs. 16.7% for HIV(+); p = .001). The vitamin D serum level was comparable in the two studied groups (74.2 ± 35.9 nmol/L for HIV(+) vs. 78.0 ± 27.6 nnmol/L for HIV(-), p = .545). In HIV-infected group, a significant positive correlation between CD4+ cell percentage and vitamin D level was observed (r = 0.17; p = .036). Furthermore, the significant negative correlation between vitamin D level and CD8+ cell percentage, PLT, CRP, and D-dimers was seen. In univariate analysis, only TAF use and AIDS status was associated with vitamin D level deficiency. No other antiretroviral (ARV) drug nor gender or smoking had influence on vitamin D serum level. In multivariate analysis, only AIDS status and CRP level were correlated with vitamin D level (slope estimate = 11.6 and p = .032 and slope estimate = -0.83 and p = .002; respectively). In summary, we report that low vitamin D level may be associated with high CRP level in HIV-infected patients on suppressive antiretroviral therapy, especially in AIDS phase. More larger studies are required to assess our observation concerning TAF use and vitamin D level in HIV-positive patients.

Keywords: CRP; HIV; hypovitaminosis D; inflammatory markers; suppressive antiretroviral therapy; tenofovir alafenamide.

MeSH terms

  • Adult
  • Aged
  • Anti-Retroviral Agents / adverse effects
  • Anti-Retroviral Agents / therapeutic use*
  • C-Reactive Protein / analysis
  • Cross-Sectional Studies
  • Female
  • Fibrin Fibrinogen Degradation Products / analysis
  • HIV Infections / complications*
  • HIV Infections / drug therapy*
  • Humans
  • Male
  • Middle Aged
  • Platelet Count
  • Risk Factors
  • Sustained Virologic Response*
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / virology*

Substances

  • Anti-Retroviral Agents
  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D
  • Vitamin D
  • C-Reactive Protein
  • 25-hydroxyvitamin D