title: Validation Protocol of Vitamin D Supplementation in Patients with HIV-Infection.
abstract: Hypovitaminosis D and secondary hyperparathyroidism are frequent among HIV-infected patients. As there are no data about the best supplementation therapy both in treatment and in maintenance, we conducted an observational study of 300 HIV-infected patients for whom vitamin D and parathormone (PTH) had been measured in order to validate a protocol of vitamin D supplementation in patients with HIV-infection. Patients with vitamin D deficiency (defined as 25(OH)D < 10 ng/mL), insufficiency (defined as 25(OH)D < 20 ng/mL), or hyperparathyroidism (PTH > 65 pg/mL) were supplemented with cholecalciferol 16.000IU (0.266 mg) weekly (if deficiency) or fortnightly (if insufficiency or high PTH levels). Rates of normalization of 25(OH)D (levels above 20 ng/mL) and PTH levels (<65 pg/mL) were analyzed. Multivariate analysis of factors related to normalization was carried out. With a median follow-up of 2 years, 82.1% of patients with deficiency and 83.9% of cases with insufficiency reached levels above 20 ng/mL. However, only 67.2% of individuals with hyperparathyroidism at baseline reached target levels (<65 pg/mL). Independent factors for not achieving PTH objective were tenofovir (TDF) and protease inhibitors use. In HIV-infected patients with hypovitaminosis, the protocol of cholecalciferol supplementation normalized vitamin D levels regardless of antiretroviral regimen in a high proportion of patients but it was less effective to correct hyperparathyroidism.
authors.affiliation: Hospital del Mar, Infectious Diseases, Barcelona, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Elisabet
authors.identifier: 0000-0003-4131-2230
authors.initials: E
authors.lastname: Lerma-Chippirraz
authors.affiliation: Hospital del Mar, Infectious Diseases, Barcelona, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Roberto
authors.initials: R
authors.lastname: Güerri-Fernández
authors.affiliation: Hospital del Mar, Infectious Diseases, Barcelona, Spain.
authors.forename: Judit
authors.initials: J
authors.lastname: Villar García
authors.affiliation: Hospital del Mar, Infectious Diseases, Barcelona, Spain.
authors.forename: Alicia
authors.initials: A
authors.lastname: González Mena
authors.affiliation: Hospital del Mar, Infectious Diseases, Barcelona, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Guelar Grinberg
authors.affiliation: Hospital del Mar, Infectious Diseases, Barcelona, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: María Milagro
authors.initials: MM
authors.lastname: Montero
authors.affiliation: Hospital del Mar, Infectious Diseases, Barcelona, Spain.
authors.forename: Luisa
authors.initials: L
authors.lastname: Sorli
authors.affiliation: Hospital del Mar, Infectious Diseases, Barcelona, Spain.
authors.forename: Sonia
authors.initials: S
authors.lastname: Calzado
authors.affiliation: Hospital del Mar, Infectious Diseases, Barcelona, Spain.
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Horcajada
authors.affiliation: Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain; Hospital del Mar, Internal Medicine, Barcelona, Spain.
authors.forename: Adolfo
authors.initials: A
authors.lastname: Díez-Pérez
authors.affiliation: Hospital del Mar, Infectious Diseases, Barcelona, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Hernando
authors.initials: H
authors.lastname: Knobel Freud