321. Vitamin D suppplementation Increases Vitamin D levels but does not imrpove inflammatory markers in HIV Infected women: A Chicago Women's Interagency HIV Study (WIHS) study
Session: Poster Abstract Session: HIV Co-morbidities
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C

Background: Vitamin D (vit D) deficiency is common in HIV+ adults and has been associated with increased inflammatory markers. Data on the impact of vit D supplementation on inflammatory markers are sparse.

Methods: Prospective study conducted 2010 -2012 among HIV+ women at 3 Chicago WIHS sites. Vit D was measured at baseline, and results and recommendations for Vit D supplementation were given to patients with insufficient vit D and their primary care providers (PCPs).  Demographic and clinical characteristics were compared among women with insufficient (<30ng/ml) vs. sufficient (≥30ng/ml) vit D at baseline using chi-square tests for categorical and Wilcoxon rank sum tests for continuous variables. Logistic regression was used to identify factors associated with achieving sufficient vit D levels (≥30ng/ml) at 6 months. Changes in PTH and inflammatory markers (IL6, hsCRP and TNFa) from baseline to 6 months were compared by supplementation status using Wilcoxon rank sum tests.

Results: At baseline, of 127 women enrolled, 92 (72%) had insufficient vit D (median, 18ng/ml) .Younger median age (44.5 vs. 51yrs; p <0.01), African-American race (83% vs. 69%; p=0.02), being HCV- (72% vs. 40%; p<0.01), and having a CD4 <500 (50% vs. 24%; p=0.02) were associated with vit D insufficiency at baseline. At 6 months, 54% of women with insufficient vit D had been prescribed vit D and 97% took prescribed vit D. Vit D prescriptions were more common among older women (p=0.058), those on HAART (p=0.002) and those with undetectable HIVRNA (p<0.001). 29% of the women achieved sufficient vit D at 6 months.  In multivariable analysis, factors associated with vit D≥30 at 6 months were having a baseline visit in winter/spring vs. summer/fall (OR 26.4; 95% CI 2.25-310.6), taking vit D supplements (OR 15.8; 95% CI 2.9-85.1), tenofovir use (OR 8.57; 95% CI1.63-45.1) and antidepressant use(OR 4.97; 95% CI1.16-21.3). Changes in PTH and inflammatory markers are shown in the table

Conclusion: Only 54% of women with insufficient vit D received vit D prescriptions at 6 month follow up even when PCPs were provided with Vit D results, and this likely reflects the lack of formal supplementation guidelines. Vit D supplementation was not associated with significant changes in PTH and or inflammatory markers.

Oluwatoyin Adeyemi, MD1, Anna Hotton, PhD, MPH2, Mariam Aziz, MD3, Kathleen Weber4, Britt Livak, MPH5, Audrey French, MD6, Crystal Winston7, Joan Swiatek3, Karen Fodor7, Mardge Cohen, MD8 and Chicago WIHS, (1)Ruth M Rothstein CORE Center, Cook County Hospital and Rush University Medical Center, Chicago, IL, (2)Chicago Developmental Center for AIDS Research (D-CFAR), Chicago, IL, (3)Rush University Medical Center, Chicago, chicago, IL, (4)CORE Center and Chicago WIHS, chicago, IL, (5)Chicago Developmental Center for AIDS Research (DCFAR), Chicago, IL, (6)John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, (7)Chicago WIHS, chicago, IL, (8)CORE Center and Chicago WIHS, Chicago, IL

Disclosures:

O. Adeyemi, None

A. Hotton, None

M. Aziz, None

K. Weber, None

B. Livak, None

A. French, None

C. Winston, None

J. Swiatek, None

K. Fodor, None

M. Cohen, None

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