High frequency of vitamin D deficiency in HIV-infected patients: effects of HIV-related factors and antiretroviral drugs

The aim of this study was to assess 25-hydroxyvitamin D (vitamin D) status in an HIV-infected adult population and to define HIV- and antiretroviral-related factors associated with vitamin D deficiency. Using data from a prospective cohort of HIV-infected adult patients followed in five French centres (DatAIDS cohort), we evaluated the prevalence of vitamin D deficiency/insufficiency (30 ng/mL). A multiple linear regression model was used to examine risk factors for vitamin D deficiency (10 ng/mL). Vitamin D deficiency/insufficiency was observed in 86.7 of the 2994 patients, including 55.6 with vitamin D insufficiency and 31.1 with vitamin D deficiency. In multivariate analysis, factors associated with vitamin D deficiency were current smoking [adjusted OR (aOR) 1.55], estimated glomerular filtration rate epsilon 90 mL/min/1.73 m(2) (aOR 1.51), vitamin D measurement not performed in summer (aOR 0.27), CD4 350 cells/mm(3) (aOR 1.37 for CD4 200 to 350 and 1.62 for CD4 200 cells/mm(3)) and antiretroviral therapy (aOR 2.61). Gender, body mass index, age, coinfection and previous AIDS were not associated factors. In the antiretroviral-treated population (n2660), besides the same factors found in the whole population, efavirenz was the only drug to be significantly associated with deficiency, with an aOR of 1.89 (95 CI 1.452.47). Vitamin D deficiency is frequent in this HIV-infected population. Patients on antiretroviral therapy are at higher risk of vitamin D deficiency than antiretroviral-naive patients, with an increased risk in patients receiving efavirenz. No effect of the other antiretrovirals, including the latest (etravirine, darunavir, raltegravir), was found.