Infectious Diseases Department, CHU, Dijon, 21079, France.
BMC Infect Dis. 2013 Jan 7;13:7. doi: 10.1186/1471-2334-13-7.
Even though it has been suggested that antiretroviral therapy has an impact on severe hypovitaminosis D (SHD) in HIV infected patients, it could be speculated that the different levels of residual inflammation on HAART (Highly Active Anti Retroviral Therapy) could contribute to SHD and aggravate bone catabolism in these patients.
A cross-sectional study was carried out in an unselected cohort of 263 HIV infected outpatients consulting during Spring 2010. Clinical examinations were performed and medical history, food habits, sun exposure and addictions were collected. Fasting blood samples were taken for immunological, virological, inflammation, endocrine and bone markers evaluations.
Ninety-five (36%) patients had SHD. In univariate analysis, a significant and positive association was found between SHD and IL6 (p = 0.001), hsCRP (p = 0.04), increased serum C-Telopeptides X (CTX) (p = 0.005) and Parathyroid Hormon (PTH) (p < 0.0001) levels. In multivariate analysis, SHD deficiency correlated significantly with increased IL-6, high serum CTX levels, lower mean daily exposure to the sun, current or past smoking, hepatitis C, and functional status (falls), but not with the time spent on the current HAART (by specific drug or overall).
SHD is frequent and correlates with inflammation in HIV infected patients. Since SHD is also associated with falls and increased bone catabolism, it may be of interest to take into account not only the type of antiretroviral therapy but also the residual inflammation on HAART in order to assess functional and bone risks. This finding also suggests that vitamin D supplementation may be beneficial in these HIV-infected patients.
尽管有研究表明抗逆转录病毒疗法对 HIV 感染患者的严重维生素 D 缺乏症（SHD）有影响，但可以推测，高效抗逆转录病毒治疗（HAART）后不同程度的残留炎症可能导致 SHD，并加重这些患者的骨代谢。
在 2010 年春季对一组未经选择的 263 名 HIV 感染门诊患者进行了横断面研究。进行了临床检查，并收集了病史、饮食习惯、日照和成瘾情况。抽取空腹血样进行免疫、病毒学、炎症、内分泌和骨标志物评估。
95 例（36%）患者存在 SHD。单因素分析显示，SHD 与白细胞介素 6（IL-6）（p=0.001）、高敏 C 反应蛋白（hsCRP）（p=0.04）、血清 C-末端肽 X（CTX）水平升高（p=0.005）和甲状旁腺激素（PTH）（p＜0.0001）显著正相关。多因素分析显示，SHD 缺乏与 IL-6 升高、高血清 CTX 水平、每日平均日照时间减少、吸烟史、丙型肝炎和功能状态（跌倒）显著相关，但与当前 HAART（特定药物或总体）持续时间无关。
SHD 在 HIV 感染患者中很常见，与炎症相关。由于 SHD 还与跌倒和骨代谢增加有关，因此不仅要考虑抗逆转录病毒治疗的类型，还要考虑 HAART 后的残留炎症，以评估功能和骨骼风险。这一发现还表明，维生素 D 补充可能对这些 HIV 感染患者有益。
