Methods: We studied newly diagnosed, treatment-naive, HIV patients, aged 18 to 50 years old. Exclusion criteria were: history of fragility bone fractures, bone metabolic disease or any secondary causes of osteoporosis. Dual-energy x-ray absorptiometry (DXA), fasting serum sample of 25OHD, CTx (bone resorption marker), PTH, TSH, testosterone, biochemical parameters, CD4 count and HIV viral load (VL) were measured. Variables such as body mass index (BMI), sunlight exposure, smoking, drug use, dairy intake, physical activity and season of sampling were analyzed. 25OHD levels of patients were compared with a control group (22 healthy volunteers) matched by age, sex and season of sampling. Student's t test with a significance level of 0.05 was employed.
Results: Sixty one male patients, mean age 31 years old (19-50 y/o), BMI 23,8 kg/m2 were recruited from June 2014 to March 2016 (57% in winter/autumn season). Median CD4 count was 365 cells/mL (85% CDC stage A) and 19 patients had a VL ≥105 copies/mL. Thirteen percent had abnormal DXA (z-score < -2.0); CTx was higher than 0.584 ng/mL (upper normal value) in only one. Mean 25OHD was significantly lower in patients (17.3 ± SD 6.6 ng/mL) versus controls (20.9 ± SD 6.9 ng/mL), p= 0.039. Vitamin D deficiency (25OHD < 20 ng/mL) was found in 68.3% of patients. Mean 25OHD in patients with VL > 105 was 14.9 ng/mL (SD 6.1), while in patients with VL <105, it was 18.9 ng/mL (SD 7.1) (p =0.044). No significant association was seen between 25OHD, DXA or CTx and other variables such as age, BMI, sunlight exposure, smoking, drug use, dairy intake and CDC stage.
Conclusion: Our findings show that in treatment-naive HIV patients, vitamin D deficiency is highly prevalent and greater that in healthy volunteers. Higher HIV viral load seems to induce lower levels of vitamin D. However, in these patients, bone involvement does not seem to be common.
M. E. Ceballos,
C. Carvajal, None
A. Dominguez, None
G. González, None