Hyperparathyroidism and complications associated with Vitamin D deficiency in HIV-infected adults in New York City, New York

Candice K. Kwan, Benjamin Eckhardt, Jonathan Baghdadi, Judith A. Aberg

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

Although recent studies report a high prevalence of vitamin D deficiency in HIV-infected adults similar to that in the general population, metabolic complications of vitamin D deficiency may be worsened with HIV infection and remain insufficiently characterized. We conducted a retrospective cross-sectional cohort study to determine prevalence and correlates of vitamin D deficiency and hyperparathyroidism among HIV-infected patients attending an urban clinic. Vitamin D deficiency was defined as 25(OH)-vitamin D <20ng/ml and insufficiency as 20 to <30ng/ml, and hyperparathyroidism as parathyroid-hormone >65 pg/ml. We used the X2 test to compare proportions and logistic regression to assess for associations. Among 463 HIV-infected patients, the prevalence of vitamin D deficiency was 59%. The prevalence of hyperparathyroidism was 30% among patients with vitamin D deficiency, 23% among those with insufficiency, and 12% among those with sufficient vitamin D levels. Vitamin D deficiency was associated with increased odds of hyperparathyroidism. Severe vitamin D deficiency was associated with elevated alkaline phosphatase, a marker for increased bone turnover. Although efavirenz use was associated with vitamin D deficiency, and protease inhibitor use with decreased odds of vitamin D deficiency, there was no statistical difference in rates of hyperparathyroidism stratified by combination antiretroviral therapy (cART) use. Given the increased risk of osteopenia with HIV infection and cART use, vitamin D supplementation for all HIV-infected patients on cART should be prescribed in accordance with the 2011 Endocrine Society guidelines. In HIV-infected patients with severe vitamin D deficiency or hyperparathyroidism, screening for osteomalacia and osteopenia may be warranted.

Original languageEnglish
Pages (from-to)825-832
Number of pages8
JournalAIDS Research and Human Retroviruses
Volume28
Issue number9
DOIs
StatePublished - 1 Sep 2012
Externally publishedYes

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