Effects of cholecalciferol supplementation on serum and urinary vitamin D metabolites and binding protein in HIV-infected youth.
Vitamin D insufficiency is widespread in HIV-infected patients. HIV and/or antiretroviral therapy (ART), particularly efavirenz (EFV), may interfere with vitamin D metabolism. However, few data from randomized, controlled trials exist. Here, we investigate changes in vitamin D metabolites and binding protein (VDBP) after 6 months of supplementation in a randomized, active-control, double-blind trial investigating 2 different monthly cholecalciferol (vitamin D3) doses [60,000 (medium) or 120,000 (high) IU/month] vs. a control arm of 18,000 IU/month in 8-25year old HIV-infected youth on ART with HIV-1 RNA <1000 copies/mL and baseline 25-hydroxycholecalciferol (25(OH)D3) ≤30ng/mL. A matched healthy uninfected group was enrolled in a similar parallel study for comparison. Changes after 6 months were analyzed as intent-to-treat within/between groups [control group (low dose) vs. combined supplementation doses (medium+high)]. At 6 months, 55% vs. 82% of subjects in control and supplementation groups, respectively, reached 25(OH)D3≥30ng/mL (P=0.01) with no difference between medium and high doses (both 82% ≥30ng/mL). There were few differences for those on EFV vs. no-EFV, except serum VDBP decreased in EFV-treated subjects (both within- and between-groups P≤0.01). There were no significant differences between the HIV-infected vs. healthy uninfected groups. The major finding of the present study is that cholecalciferol supplementation (60,000 or 120,000 IU/month) effectively raises serum 25(OH)D3in the majority of HIV-infected subjects, regardless of EFV use. Notably, response to supplementation was similar to that of uninfected subjects.
Medical University of South Carolina, Charleston, SC, United States; Emory University School of Medicine, Atlanta, GA, United States. Electronic address: eckarda@musc.edu.
Allison Ross
AR
Eckard
Morehouse School of Medicine, Atlanta, GA, United States.
Myrtle
M
Thierry-Palmer
Morehouse School of Medicine, Atlanta, GA, United States.
Natalia
N
Silvestrov
Emory University School of Medicine, Atlanta, GA, United States.
Julia C
JC
Rosebush
Case Western Reserve University Cleveland, OH, United States.
Mary Ann
MA
O'Riordan
Emory University School of Medicine, Atlanta, GA, United States.
Julie E
JE
Daniels
Emory University School of Medicine, Atlanta, GA, United States.
Monika
M
Uribe-Leitz
Case Western Reserve University Cleveland, OH, United States.
Danielle
D
Labbato
Emory University School of Medicine, Atlanta, GA, United States.
Joshua H
JH
Ruff
Mayo Clinic, Rochester, MN, United States.
Ravinder J
RJ
Singh
Emory University School of Medicine, Atlanta, GA, United States.
Vin
V
Tangpricha
Case Western Reserve University Cleveland, OH, United States.
Grace A
GA
McComsey
D000293:Adolescent; D000328:Adult; D000480:Alkynes; D048588:Benzoxazines / Q000627:therapeutic use; D002762:Cholecalciferol / Q000627:therapeutic use*; D003521:Cyclopropanes; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000188:drug therapy; D006801:Humans; D008297:Male; D011485:Protein Binding; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood* / Q000652:urine*; D014808:Vitamin D Deficiency / Q000097:blood; D014809:Vitamin D-Binding Protein / Q000097:blood* / Q000652:urine*; D055815:Young Adult
D000480:Alkynes; D048588:Benzoxazines; D003521:Cyclopropanes; D014809:Vitamin D-Binding Protein; D014807:Vitamin D; D002762:Cholecalciferol; C104450:25-hydroxyvitamin D; C098320:efavirenz
Cholecalciferol supplementation; HIV; Pediatrics and adolescents; Randomized-controlled trial; Vitamin D; Vitamin d binding protein; Vitamin d metabolites