Kim Jong Hun, Gandhi Vani, Psevdos George, Espinoza Fabiola, Park Joyce, Sharp Victoria
Division of Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
AIDS Res Hum Retroviruses. 2012 Mar;28(3):235-41. doi: 10.1089/AID.2011.0040. Epub 2011 Jul 6.
Few studies have examined the vitamin D status in HIV-infected patients. A cross-sectional retrospective chart review of 2992 HIV-infected patients was conducted from 9/2008 to 5/2009. A total of 274 adult patients had 25-hydroxyvitamin D [25(OH)D] obtained by radioimmunoassay. None was receiving vitamin D (vitD) supplements. Vitamin D status was defined as the following: vitD deficiency (vitDd) as 25(OH)D <25 nmol/liter, vitD insufficiency (vitDi) as 25(OH)D 25-74 nmol/liter, and vitD optimal (vitDo) as 25(OH)D ≥75 nmol/liter. We analyzed demographic/laboratory data. vitDd, vitDi, and vitDo were 21.2% (58 patients, 58/274), 68.6% (188 patients, 188/274), and 10.2% (28 patients, 28/274), respectively. There were significant racial differences. Blacks were 60.3% (35 patients, 35/58), 40.4% (76 patients, 76/188), and 28.6 % (8 patients, 8/28) in vitDd, vitDi, and vitDo, respectively, p=0.002. CD4 T cell count was not different in these three groups. However, HIV viral load was significantly different. Median log (10) HIV viral load was 2.31 with IQR 1.70-409, 1.70 with IQR 1.70-2.96, and 1.70 with IQR 1.70-2.78 in vitDd, vitDi, and vitDo, respectively, p=0.039. Multivariate logistic regression analysis showed that black race [odd ratio (OR) 4.108, 95% confidence interval (CI) 1.462-11.543, p=0.007] and HIV viral load>50 copies/ml (OR 2.396, 95% CI 1.120-5.127, p=0.024) were significantly associated with vitamin D deficiency. Vitamin D deficiency was highly prevalent in HIV-infected patients. Detectable HIV viremia and dark skin (black ethnicity) were significantly associated with vitamin D deficiency. Evaluation of vitamin D status in HIV-infected patients should be considered and further studies are needed to define the effects of vitamin D.
很少有研究检测过HIV感染患者的维生素D状况。在2008年9月至2009年5月期间，对2992例HIV感染患者进行了一项横断面回顾性图表审查。共有274例成年患者通过放射免疫分析法检测了25-羟维生素D[25(OH)D]。没有人正在服用维生素D补充剂。维生素D状况定义如下：维生素D缺乏（vitDd）为25(OH)D<25nmol/L，维生素D不足（vitDi）为25(OH)D25 - 74nmol/L，维生素D最佳（vitDo）为25(OH)D≥75nmol/L。我们分析了人口统计学/实验室数据。vitDd、vitDi和vitDo分别为21.2%（58例患者，58/274）、68.6%（188例患者，188/274）和10.2%（28例患者，28/274）。存在显著的种族差异。黑人在vitDd、vitDi和vitDo中分别占60.3%（35例患者，35/58）、40.4%（76例患者，76/188）和28.6%（8例患者，8/28），p = 0.002。这三组的CD4 T细胞计数没有差异。然而，HIV病毒载量有显著差异。vitDd、vitDi和vitDo组的HIV病毒载量中位数log(10)分别为2.31，四分位间距为1.70 - 4.09，1.70，四分位间距为1.70 - 2.96，以及1.70，四分位间距为1.70 - 2.78，p = 0.039。多因素逻辑回归分析显示，黑人种族[比值比（OR）4.108，95%置信区间（CI）1.462 - 11.543，p = 0.007]和HIV病毒载量>50拷贝/ml（OR 2.396，95%CI 1.120 - 5.127，p = 0.024）与维生素D缺乏显著相关。维生素D缺乏在HIV感染患者中非常普遍。可检测到的HIV病毒血症和深色皮肤（黑人种族）与维生素D缺乏显著相关。应考虑对HIV感染患者的维生素D状况进行评估，并且需要进一步研究来确定维生素D的作用。
