title: Factors associated with vitamin D deficiency in a population of 2044 HIV-infected patients.
abstract: OBJECTIVE
  The high prevalence of vitamin D deficiency in HIV-infected patients has been demonstrated but there are still controversies regarding to the role of antiretroviral therapy (ART) in this setting. The aims of this study was to validate factors associated with vitamin D deficiency in a large cohort of HIV-infected patients.
  
  
  METHODS
  A retrospective analysis of 2044 consecutive patients from December 2005 to March 2011 was conducted. Factors independently associated with vitamin D deficiency (<30 ng/ml and <10 ng/ml) were analyzed. Vitamin D levels were compared according to CD4 count, viral load and ART modalities.
  
  
  RESULTS
  vitamin D was <30 ng/ml in 89.2% and <10 ng/ml in 32.4%. The median value was 13.8 ng/ml (4-102). Winter season, female sex, heterosexual acquisition of HIV, the need of second lines (complex and sequential treatment modalities) and a longer duration of ART were independently associated with vitamin D deficiency (<30 ng/ml). CD4 count <200/μl, advanced stages of disease and the current efavirenz use were independently associated with severe vitamin D deficiency (<10 ng/ml). Median vitamin D levels was 14.1 ng/dl when CD4 ≥200/μl, 11.5 ng/dl when CD4<200 (p = 0.0003). The ART modalities had a significant influence on vitamin D concentrations, the highest vitamin D level was observed in the absence of treatment.
  
  
  CONCLUSIONS
  In HIV-infected patients, vitamin D deficiency is associated with ART modalities and duration. The most severe vitamin D deficiencies are associated with low CD4 count, the use of efavirenz and advanced stages of disease severity.
authors.affiliation: Internal Medicine, CHU Saint Pierre, Université libre de Bruxelles, Bruxelles, Belgium.
authors.forename: Maria
authors.initials: M
authors.lastname: Theodorou
authors.affiliation: Hepato-Gastroenterology and Clinical nutrition, CHU Saint Pierre, Université libre de Bruxelles, Bruxelles, Belgium. Electronic address: thomas.serste@skynet.be.
authors.forename: Thomas
authors.initials: T
authors.lastname: Sersté
authors.affiliation: Hepato-Gastroenterology and Clinical nutrition, CHU Saint Pierre, Université libre de Bruxelles, Bruxelles, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Van Gossum
authors.affiliation: Infectious Diseases, CHU Saint Pierre, Université libre de Bruxelles, Bruxelles, Belgium.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Dewit
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000480:Alkynes; D048588:Benzoxazines / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D003521:Cyclopropanes; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D019562:Viral Load; D014807:Vitamin D / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000480:Alkynes; D048588:Benzoxazines; D003521:Cyclopropanes; D014807:Vitamin D; C098320:efavirenz
keywords: Antiretroviral therapy; Associated factors; HIV; Vitamin D