TITLE:
Vitamin D and Secondary Hyperparathyroidism in HIV Infected Patients Taking Antiretroviral Therapy
AUTHORS:
Huylmer Lucena Chaves, Henrique Pires Moreira, Hayato Augusto Hossoé Corrêa, William Browne de Oliveira Machado, Rian Brito Teles, Lucigleyson Ribeiro do Nascimento, Janedson Baima Bezerra Filho, Camilla Camuza Coelho Rabelo Queiroz, Danilo Gonçalves Nóbrega, Ana Carolina Vasconcelos Moreira, Maria Carolina Nunes Albano de Meneses, Fabrício de Maicy Bezerra, Melissa Soares Medeiros
KEYWORDS:
HIV, Hyperparathyroidism, Vitamin D, Antiretroviral Therapy
JOURNAL NAME:
World Journal of AIDS,
Vol.4 No.4,
December
11,
2014
ABSTRACT: Objective: Due to the lack
of studies assessing hypovitaminosis D and secondary hyperparathyroidism in
Brazilian HIV-infected population, especially in the northeastern population,
this study aimed to determine the profile of these conditions in patients
infected with HIV and its correlation with immuno-virological, sociodemographic
data and associated comorbidities. Methods: Comparison studies were obtained
from routine clinical samples of HIV infected patients submitted for 25-OH
Vitamin D, PTH and alkaline phosphatase determination. Results: A total of 78
patients were included, 42 (53.8%) males, mean age 45.7 years. Antiretroviral
regimens most used in this study
were Zidovudine/Lamivudine/Efavirenz 17.9%, Tenofovir/Lamivudine/Efavirenz
17.9%,Tenofovir/Lamivudine/Atazanavir-r 15.4%. The mean value CD4 count was
592.1 ± 247.2 cells/mm3, CD8
cell count was 1026.5 ± 467.3 cells/mm3, mean detectable viral load
was 2220 ± 15703 copies and CD4/CD8 ratio was 0.63 ± 0.33.
A total of 34 vitamin D dosages were collected with 41.2% representing
sufficient amount and 58.8% insufficient. Alkaline Phosphatase (ALP) dosage was
elevated in 49.3% (N=35) of the patients. Parathormone (PTH) was elevated in
18% (N = 11). Among patients with elevated PTH levels, 81.9% had elevated
levels of ALP (p = 0.01). In the group of patients with high levels of ALP,
45.7% had a CD4 count 3 (p = 0.02). There was no significant
difference in vitamin D related to gender (p = 0.21), age (p = 0.23), CD4 count
(p = 0.26), suppressed viral load (p = 0.44) or blood glucose (p = 0.45).
Conclusions: This study evidenced a high prevalence of Vitamin D insufficiency
in Northeast Brazil, which suggests HIV infection correlation. A high
prevalence of Hyperparathyroidism was detected and related with inflammatory
condition persistence and low CD4 count. We suggest improve vitamin D follow up
and measurements in this population with better CD4 count control to avoid
future osteoarticular complications of HIV treatment.