430. Predictors of Vitamin D deficiency among HIV patients in an urban ambulatory clinic
Session: Poster Abstract Session: HIV Challenges and Complications
Friday, October 21, 2011
Room: Poster Hall B1
Handouts
  • VITAMIN Dposter-1-3-1-3.pdf (568.2 kB)
  • Background: Vitamin D insufficiency/deficiency has been shown to be highly prevalent in several HIV outpatient ambulatory settings, but there is limited data on unique predictors in this population.   

    Methods: To determine characteristics associated with vitamin D insufficiency/deficiency in a southern urban center cohort, charts from a convenience sample of 185 patients were retrospectively reviewed

    Results: Characteristics of the convenience sample were as follows: 78.4% African American (AA), 48.6% women, 51.4% > 50 years of age, median CD4 count 388 mm/3, median HIV RNA level 388 copies, mean body mass index (BMI) 26.5 kg/m2 and mean albumin 3.8 gm/dl.  52% were currently taking tenofovir.  Proportions with vitamin D levels < 10 ng/ml, 10 – 20 ng/ml, 20 – 30 ng/ml and > 30 ng/ml were 14.6%, 44.8%, 24.9%, and 15.7%, respectively.  

    On bivariate analyses, factors associated with vitamin D levels < 20 ng/ml were a lower albumin level (p = 0.02), sex  (P= 0.0003) and AA race (P = 0.0001). Tenofovir exposure showed a trend towards significance (59% with levels < 20 ng/ml vs. 47% with levels > 20 ng/ml (P = 0.09).   AA race was the only factor which remained significant in multivariate modeling.  Of the 31 patients with available DEXA scan information, 18 had osteopenia and 6 had osteoporosis. Among the 18 patients with osteopenia, 16 (89%) had vitamin D < 30ng/ml and all the patients with osteoporosis had vitamin D levels < 30ng/ml.

    Table 1.Associations between Vitamin D deficiency and risk factors in an HIV infected population 

     
    Risk factor OR Crude  95% CI OR adjusted 95% CI
    Race (AA vs W) 6.0 2.7-13.3 4.2 1.8-10.1
    Gender (F vs. M) 2.6 1.4-4.8 1.7 0.9-3.4
    TDF( yes vs. no) 1.7 0.9-3.0 1.9 0.8-2.9
    Age(=<50 vs.> 50)   1.3 0.8-2.5 1.1 0.6-1.9
    Albumin (low vs. normal) 1.5 1.1-3.3 1.4 0.8-2.5

     

    Conclusion: Similar to other described populations, vitamin D insufficiency/deficiency was predictably high.  AA race was a strong independent risk factor.  Although not significant, obese persons with a poorer nutritional status and possibly those on tenofovir may also be at higher risk.  Patients with osteopenia or osteoporosis often had lower levels of vitamin D.


    Subject Category: H. HIV/AIDS and other retroviruses

    John Nnadi, MD1, Frontini Maria, PHD2, Tehmina Khan, MD2, Sam Bairu, MD2, Jigar Chotalia, MPH3 and Rebecca Clark, MD, PhD4, (1)Department of Infectious Disease, Louisiana State University,New Orleans , New Orleans , LA, (2)Louisiana State University,New Orleans , New Orleans , LA, (3)School of public health, Louisiana State University,New Orleans , New Orleans , LA, (4)Louisiana State University, New Orleans, LA

    Disclosures:

    J. Nnadi, None

    F. Maria, None

    T. Khan, None

    S. Bairu, None

    J. Chotalia, None

    R. Clark, None

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