title: High frequency of vitamin D deficiency in HIV-infected patients: effects of HIV-related factors and antiretroviral drugs.
abstract: OBJECTIVE
  The aim of this study was to assess 25-hydroxyvitamin D (vitamin D) status in an HIV-infected adult population and to define HIV- and antiretroviral-related factors associated with vitamin D deficiency.
  
  
  METHODS
  Using data from a prospective cohort of HIV-infected adult patients followed in five French centres (Dat'AIDS cohort), we evaluated the prevalence of vitamin D deficiency/insufficiency (<30 ng/mL). A multiple linear regression model was used to examine risk factors for vitamin D deficiency (≤10 ng/mL).
  
  
  RESULTS
  Vitamin D deficiency/insufficiency was observed in 86.7% of the 2994 patients, including 55.6% with vitamin D insufficiency and 31.1% with vitamin D deficiency. In multivariate analysis, factors associated with vitamin D deficiency were current smoking [adjusted OR (aOR) 1.55], estimated glomerular filtration rate ≥90 mL/min/1.73 m(2) (aOR 1.51), vitamin D measurement not performed in summer (aOR 0.27), CD4 <350 cells/mm(3) (aOR 1.37 for CD4 200 to <350 and 1.62 for CD4 <200 cells/mm(3)) and antiretroviral therapy (aOR 2.61). Gender, body mass index, age, coinfection and previous AIDS were not associated factors. In the antiretroviral-treated population (n = 2660), besides the same factors found in the whole population, efavirenz was the only drug to be significantly associated with deficiency, with an aOR of 1.89 (95% CI 1.45-2.47).
  
  
  CONCLUSIONS
  Vitamin D deficiency is frequent in this HIV-infected population. Patients on antiretroviral therapy are at higher risk of vitamin D deficiency than antiretroviral-naive patients, with an increased risk in patients receiving efavirenz. No effect of the other antiretrovirals, including the latest (etravirine, darunavir, raltegravir), was found.
authors.affiliation: Maladies Infectieuses et Tropicales, CHU Nantes, Nantes, France. clotilde.allavena@chu-nantes.fr
authors.forename: C
authors.initials: C
authors.lastname: Allavena
authors.forename: C
authors.initials: C
authors.lastname: Delpierre
authors.forename: L
authors.initials: L
authors.lastname: Cuzin
authors.forename: D
authors.initials: D
authors.lastname: Rey
authors.forename: N
authors.initials: N
authors.lastname: Viget
authors.forename: J
authors.initials: J
authors.lastname: Bernard
authors.forename: P
authors.initials: P
authors.lastname: Guillot
authors.forename: C
authors.initials: C
authors.lastname: Duvivier
authors.forename: E
authors.initials: E
authors.lastname: Billaud
authors.forename: F
authors.initials: F
authors.lastname: Raffi
mesh_terms: D000328:Adult; D000480:Alkynes; D044966:Anti-Retroviral Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D048588:Benzoxazines / Q000008:administration & dosage / Q000009:adverse effects; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003521:Cyclopropanes; D005260:Female; D005602:France; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014808:Vitamin D Deficiency / Q000139:chemically induced* / Q000453:epidemiology*
chemical_list: D000480:Alkynes; D044966:Anti-Retroviral Agents; D048588:Benzoxazines; D003521:Cyclopropanes; C098320:efavirenz