HIV 感染儿童和青年中维生素 D 缺乏和不足。

Vitamin D deficiency and insufficiency in HIV-infected children and young adults.

机构信息

From the *Unité de Recherche Clinique Paris Centre, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris; †CIC P0901 Mère Enfant, Inserm, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris, Université Paris Descartes; ‡EA3620, Université Paris Descartes, Sorbonne Paris-Cité; §Unité d'Immunologie et Hématologie Pédiatriques; ¶Urgences Pédiatriques, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris; ‖Laboratoire d'Ethique Médicale, Université Paris Descartes, Paris; **Centre d'Examens de Santé de la Caisse Primaire d'Assurance Maladie de la Seine-Saint-Denis, Bobigny; ††Service d'Explorations Fonctionnelles, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris; ‡‡INSERM U845, équipe Homéostasie du Phosphate, Université Paris Descartes; §§Pharmacologie, Groupe Hospitalier Broca Cochin Hôtel Dieu; and ¶¶Service de Physiologie et Explorations Fonctionnelles, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France.J.-M.T. and M.C. contributed equally to the study.

出版信息

Pediatr Infect Dis J. 2013 Nov;32(11):1240-4. doi: 10.1097/INF.0b013e3182a735ed.

DOI:10.1097/INF.0b013e3182a735ed

PMID:23907260

Abstract

BACKGROUND

Vitamin D insufficiency and HIV infection are both risk factors for chronic disorders, so it is important to consider vitamin D status in HIV-infected patients.

METHODS

We prospectively investigated serum 25-hydroxyvitamin D (25(OH)D) concentrations, determined by radioimmunoassay, in 113 HIV-infected children (age≤24 years) and 54 healthy controls matched for age and phototype. We assessed the prevalence of vitamin D deficiency and insufficiency (VDD and VDI) defined as 25(OH)D titers of <10 ng/mL and between 10 and 30 ng/mL, respectively, and their predictive factors.

RESULTS

The overall prevalence of VDD and VDI was 38.9% and 58.7%, respectively. Mean serum 25(OH)D concentrations were significantly higher in the HIV group than the control group (14.2±6.9 ng/mL vs. 10.4±5 ng/mL, P<0.001). Variables significantly associated with low serum 25(OH)D concentrations in HIV-infected children were dark phototype (P<0.001) and age (r=-0.19, P=0.03). Patients receiving efavirenz had a trend toward lower serum 25(OH)D concentrations (11.1±4.6 ng/mL vs. 14.6±7 ng/mL, P=0.1). Dark phototype was the only independent risk factor for VDD in HIV-infected children (odds ratio=14.6; 95% confidence interval: 2.4-89.9, P=0.004).

CONCLUSIONS

VDD and VDI were common in both HIV-infected and control groups, and serum 25(OH)D concentrations were significantly lower in controls than in HIV-infected children.

摘要

背景

维生素 D 不足和 HIV 感染都是慢性疾病的危险因素，因此在 HIV 感染者中考虑维生素 D 状态很重要。

方法

我们前瞻性地研究了 113 例 HIV 感染儿童（年龄≤24 岁）和 54 例年龄和肤色相匹配的健康对照者的血清 25-羟维生素 D（25(OH)D）浓度，用放射免疫法测定。我们评估了维生素 D 缺乏和不足（VDD 和 VDI）的患病率，定义为 25(OH)D 滴度<10ng/ml 和 10-30ng/ml 之间，并评估了其预测因素。

结果

VDD 和 VDI 的总患病率分别为 38.9%和 58.7%。HIV 组的血清 25(OH)D 浓度明显高于对照组（14.2±6.9ng/ml 比 10.4±5ng/ml，P<0.001）。与 HIV 感染儿童血清 25(OH)D 浓度低相关的变量有深色肤色（P<0.001）和年龄（r=-0.19，P=0.03）。接受依非韦伦治疗的患者血清 25(OH)D 浓度有降低的趋势（11.1±4.6ng/ml 比 14.6±7ng/ml，P=0.1）。深色肤色是 HIV 感染儿童 VDD 的唯一独立危险因素（比值比=14.6；95%可信区间：2.4-89.9，P=0.004）。