title: Prevalence of hypovitaminosis D and factors associated with vitamin D deficiency and morbidity among HIV-infected patients enrolled in a large Italian cohort.
abstract: BACKGROUND
  A high prevalence of hypovitaminosis D (hypD) in HIV-infected patients has been reported, but reasons are unclear.
  
  
  METHODS
  The 25 hydroxy vitamin D (vitD) concentration was measured in a sample of HIV-positive patients from Italy enrolled in the Icona Foundation Study. The change in absolute levels of vitD pre/post combination antiretroviral treatment was modelled by linear regression controlling for confounders and seasonality. Factors associated with hypD were identified using logistic regression analysis, and survival analysis was employed to evaluate the prognostic value of vitD concentration to predict severe diseases (diabetes, cardiovascular, renal), AIDS, and death.
  
  
  RESULTS
  We studied 810 patients contributing 1408 vitD measures. Median age was 36 years (range: 20-69). VitD insufficiency (30-75 nmol/L) and deficiency (<30 nmol/L) were found in 47% and 6% of the measures. Factors independently associated with vitD deficiency were African or Centre/South American nationality [odds ratio (OR): 4.16 vs. European, P = 0.04], the sample being collected in spring (OR: 11.27, P = 0.001) or in winter (OR: 4.22, P = 0.03) vs. summer, and a previous history of severe diseases (OR: 5.43, P = 0.03) or AIDS (OR: 2.44, P = 0.04). Over a median follow-up of 6.3 years, patients with vitD insufficiency were at higher risk of subsequent severe diseases than those with normal levels (relative hazard = 1.60, P = 0.05).
  
  
  CONCLUSIONS
  Our analysis shows that despite the relatively young age of our HIV-infected population, the prevalence of hypD was high. Classic risk factors for hypD in the general population were confirmed in this setting. HypD seems to be moderately associated with the risk of severe disease, AIDS, and death.
authors.affiliation: Mineral Metabolism Unit-Gorizia Civil Hospital, Gorizia, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Vescini
authors.forename: Alessandro
authors.initials: A
authors.lastname: Cozzi-Lepri
authors.forename: Marco
authors.initials: M
authors.lastname: Borderi
authors.forename: Maria Carla
authors.initials: MC
authors.lastname: Re
authors.forename: Franco
authors.initials: F
authors.lastname: Maggiolo
authors.forename: Andrea
authors.initials: A
authors.lastname: De Luca
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cassola
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Vullo
authors.forename: Giampiero
authors.initials: G
authors.lastname: Carosi
authors.forename: Andrea
authors.initials: A
authors.lastname: Antinori
authors.forename: Valerio
authors.initials: V
authors.lastname: Tozzi
authors.forename: Antonella Darminio
authors.initials: AD
authors.lastname: Monforte
mesh_terms: D000328:Adult; D000349:Africa / Q000208:ethnology; D000368:Aged; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000150:complications; D002489:Central America / Q000208:ethnology; D003920:Diabetes Mellitus / Q000209:etiology; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000150:complications; D012307:Risk Factors; D012621:Seasons; D013020:South America / Q000208:ethnology; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000150:complications / Q000208:ethnology* / Q000209:etiology*; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents; D014807:Vitamin D; C104450:25-hydroxyvitamin D