448. HIV-infected and HIV-hepatitis C-co-infected Veterans have much higher rates of vitamin D deficiency and insufficiency compared to hepatitis C-infected veterans in South Texas
Session: Poster Abstract Session: HIV Challenges and Complications
Friday, October 21, 2011
Room: Poster Hall B1
Background: 

Association between human immunodeficiency virus (HIV) infection and vitamin D deficiency is receiving burgeoning recognition. We hypothesized that HIV infection and/or treatment predisposed patients to vitamin D deficiency (VDD; 25 (OH)D level < 20 ng/mL) or insufficiency (25 (OH)D level < 30 ng/mL).  

Methods: 

In this cross-sectional study, we determined the serum 25-hydroxy vitamin D (25 (OH)D) levels and the associated factors for vitamin D deficiency/insufficiency (VDD/I) in an adult HIV population and compared the levels to those in patients with hepatitis C virus (HCV) infection.  This study was conducted in patients seen at the South Texas Veterans Healthcare System HIV and Hepatology clinics from 12/1/09 to 6/3/10. There were 347 subjects: group A (HIV-infected; N=203); B (HIV- and HCV-co-infected; N=49); and C (HCV infection; N=95).  Participants were predominately male (97%) and of white/Hispanic ethnicity (82%).  Cross-group comparisons were done using Student's t test or ANOVA, and chi-square test or Fisher's exact test.  Multivariate logistic regression models were utilized to determine risk factors for VDD/I.

Results: 

Groups A and B had a significantly higher prevalence of VDD/I compared to group C (87.2% and 84%, versus 72.6%, respectively; p = 0.002) and more severe deficiency (<10 ng/mL) (17.7% and 16.3%, versus 6.3%, respectively; p = 0.008). Factors associated with VDD included HIV positivity (OR: 2.62, 95% CI: 1.45-4.74), higher BMI (OR: 1.07, 95% CI: 1.02-1.12), higher globulin levels (a marker of inflammation; OR: 1.59, 95% CI: 1.11-2.27), winter measurement (OR: 2.11, 95% CI: 1.17-3.80), and efavirenz usage (OR: 2.22, 95% CI: 1.23-4.01).

Conclusion:

VDD/I is highly prevalent in American Veterans with HIV infection and/or hepatitis C. Despite similarities in demographics and lifestyle between HIV and hepatitis C patients, HIV patients had higher rates of VDD/I.  There was an association of VDD with HIV positivity, higher BMI, efavirenz usage, globulin level, and measurement during winter. We propose that the assessment of vitamin D status should be routinely performed in all HIV and hepatitis C patients because of the high rate of VDD/I in these persons, even in an area with a high annual number of sunny days, such as South Texas.


Subject Category: H. HIV/AIDS and other retroviruses

Mariejane Braza, MD, Medicine/Infectious Diseases, University of Texas Health Science Center at San Antonio and South Texas Veterans Health Care System, San Antonio, TX, Hemant Kulkarni, MD, South Texas Veterans Healthcare System and University of Texas Healthy Science Center at San Antonio, San Antonio, TX, Park Won, DO, Medicine, University of Texas Health Science Center at San Antonio, San Antonio , TX, Kathryn Dzintars, PharmD, South Texas Veterans Healthcare System and University of Texas Health Science Center at San Antonio, San Antonio, TX, Amy Webb, MD, Hepatology, SOuth Texas Veterans Healthcare System , San Antonio, TX and Gregory Anstead, MD, PhD, Medicine, South Texas Veterans Healthcare System, San Antonio, TX; Medicine-infectious diseases, University of Texas Health Science Center at San Antonio, San Antonio , TX

Disclosures:

M. Braza, None

H. Kulkarni, None

P. Won, None

K. Dzintars, None

A. Webb, None

G. Anstead, Gilead : Scientific Advisor, Salary
VIIV: Grant Investigator, Research grant
Merck: Scientific Advisor, Salary

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