title: Highly prevalent vitamin D deficiency and insufficiency in an urban cohort of HIV-infected men under care.
abstract: Vitamin D deficiency and insufficiency are often unappreciated in men. This cross-sectional period-prevalence study was conducted in private practice between November 20, 2008 and January 22, 2009 at latitude N 40, 46 minutes. HIV-infected men presenting for routine care without clinical disease or use of medications known to interfere with vitamin D metabolism were evaluated. Current receipt protease inhibitor (PI) and non-nucleoside reverse transcriptase inhibitor (NNRTI) were determined. Vitamin D deficiency was defined as 25-[OH] D less than 50 nmol/L, severe deficiency as less than 25 nmol/L, and insufficiency as greater than 50 nmol/L but less than 75 nmol/L. Sixty-two men, median CD4 count 541 cells per microliter, 85.5% viral load less than 200 copies per milliliter, were evaluated. A total of 30.7% were receiving a NNRTI and 59.7% a PI; 41.9% were vitamin D-deficient (11.3% severe deficiency), 33.9% insufficient, and 24.2% sufficient, p = < 0.0001. Median vitamin D: 42.4 versus 64.9 nmol/L NNRTI and PI recipients, respectively, p = 0.0017. Percentage deficient: 73.7 (14/19) NNRTI versus 29.7 (11/37) PI recipients, p = 0.0017 OR 6.62 (95% confidence interval [CI] 1.91-22.89). Tobacco use correlated with severe deficiency, p = 0.032. In conclusion, vitamin D deficiency and insufficiency were highly prevalent in these urban men irrespective of stable viral suppression. NNRTI receipt and tobacco use may be associated with lower vitamin D levels and greater risk of deficiency, and severe deficiency, respectively.
authors.affiliation: Infectious Disease Division, Department of Medicine, New York Hospital Queens, New York, New York 11367, USA. pjw9003@nyp.org
authors.forename: Peter
authors.initials: P
authors.lastname: Wasserman
authors.forename: David S
authors.initials: DS
authors.lastname: Rubin
mesh_terms: D000367:Age Factors; D003430:Cross-Sectional Studies; D008401:Gas Chromatography-Mass Spectrometry; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D015995:Prevalence; D011480:Protease Inhibitors / Q000009:adverse effects*; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects*; D012307:Risk Factors; D012880:Skin Pigmentation; D012907:Smoking; D014505:Urban Population; D014808:Vitamin D Deficiency / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*
chemical_list: D011480:Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors