Ultraviolet index and location are important determinants of vitamin D status in people with human immunodeficiency virus.
This study aimed to document the vitamin D status of HIV-infected individuals across a wide latitude range in one country and to examine associated risk factors for low vitamin D. Using data from patients attending four HIV specialist clinics across a wide latitude range in Australia, we constructed logistic regression models to investigate risk factors associated with 25(OH)D < 75 nmol L(-1). 1788 patients were included; 87% were male, 76% Caucasian and 72% on antiretroviral therapy. The proportion with 25(OH)D < 50 nmol L(-1) was 27%, and <75 nmol L(-1) was 54%. Living in Melbourne compared with Cairns (adjusted odds ratio (aOR) 3.30; 95% CI 2.18, 4.99, P < 0.001) and non-Caucasian origin (aOR 2.82, 95% CI 2.12, 3.75, P < 0.001) was associated with an increased risk, while extreme UV index compared with low UV index was associated with a reduced risk (aOR 0.33; 95% CI 0.20, 0.55, P < 0.001) of 25(OH)D < 75 nmol L(-1). In those with biochemistry available (n = 1117), antiretroviral therapy was associated with 25(OH)D < 75 nmol L(-1); however, this association was modified by serum cholesterol status. Location and UV index were the strongest factors associated with 25(OH)D < 75 nmol L(-1). Cholesterol, the product of an alternative steroid pathway with a common precursor steroid, modified the effect of antiretroviral therapy on serum 25(OH)D.
North West Academic Centre, University of Melbourne, Western Health, St Albans, Vic., Australia; Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic., Australia.
Karen M
KM
Klassen
Christopher K
CK
Fairley
Michael G
MG
Kimlin
Mark
M
Kelly
Tim R H
TR
Read
Jennifer
J
Broom
Darren B
DB
Russell
Peter R
PR
Ebeling
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001315:Australia; D002112:Calcifediol / Q000097:blood*; D002784:Cholesterol / Q000097:blood; D002947:Cities; D003430:Cross-Sectional Studies; D005260:Female; D005843:Geography; D006678:HIV / Q000187:drug effects / Q000276:immunology*; D015658:HIV Infections / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D044469:Racial Groups; D012189:Retrospective Studies; D012307:Risk Factors; D014466:Ultraviolet Rays; D014808:Vitamin D Deficiency / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000276:immunology
D002784:Cholesterol; D002112:Calcifediol