Vitamin D levels and their impact on mineral metabolism in HIV infected patients: an exploratory study.

UNLABELLED: Vitamin D has immunomodulating properties. The nuclear receptor for vitamin D is expressed in several immune cells, which convert 25-hydroxyvitamin D (25OHD) to the active form 1,25 hydroxyvitamin D [1,25(OH)D]. Under conditions of infection, 1,25(OH)D promotes production of cathelicidin (an antimicrobial peptide) in monocytes and activated macrophages.studies have shown the ability of cathelicidin to inhibit replication of human immunodeficiency virus (HIV-1) in T CD4 lymphocytes and macrophages. OBJECTIVE: To evaluate vitamin D levels and their impact on mineral metabolism in HIV infected patients. MATERIALS AND METHODS: Seventy-four clinical records of HIV/AIDS patients seen at the outpatients clinic were reviewed. The following data were collected: age, sex, time since diagnosis of HIV, HIV-1 viral load, CD4 counts (absolute value and percentage), and mineral metabolism determinations: 25OHD, intact parathormone (iPTH); serum calcium (sCa); serum phosphorus (sP) and serum crosslaps (sCTX). Vitamin D levels were stratified as follows: optimal: ≥30ng/ml; insufficient: 21-29ng/ml; moderately deficient: 20≥ -25OHD- >10 ng/ml and severely deficient ≤10 ng/ml. RESULTS: Fifty-five clinical records were included; 82% of patients had 25OHD levels below 30ng/ml (insufficient: 23.6%, moderately deficient: 36.4%; and severely deficient: 21.8%). A significantly higher serum PTH levels in the moderately and severely deficient groups than in the optimal and insufficient groups was observed (p<0.05 and p<0.03 respectively). A weak negative correlation was observed between serum 25OHD and PTH levels (r=-0.268; p<0.004). CONCLUSION: Sub-optimal vitamin D levels are frequently observed in HIV/AIDS patients on antiretroviral therapy (ART). Systematic assessment of mineral metabolism is considered necessary in HIV/AIDS positive patients.