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

Lerma-Chippirraz, Elisabet; Güerri Fernández, Roberto; Villar García, Judit; González Mena, Alicia; Guelar Grinberg, Ana; Montero, M.; Sorli Redó, M. Luisa; Calzado, Sonia; Horcajada Gallego, Juan Pablo; Díez Pérez, Adolfo; Knobel Freud, Hernando

doi:http://dx.doi.org/10.1155/2016/5120831

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

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Lerma-Chippirraz E, Güerri-Fernández R, Villar García J, González Mena A, Guelar Grinberg A, Montero MM. Validation Protocol of Vitamin D Supplementation in Patients with HIV-Infection. AIDS Res Treat. 2016;2016:5120831

Abstract

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.