Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
UCL Centre for Nephrology, Royal Free Hospital, University College London, London, UK.
HIV Res Clin Pract. 2020 Oct;21(5):115-120. doi: 10.1080/25787489.2020.1836900. Epub 2020 Oct 19.
Hypercalcemia is an uncommon finding in people living with HIV (PLHIV). Causes of hypercalcemia in PLHIV have not been well documented. As such, we studied the causes of hypercalcemia in PLHIV.
We conducted a retrospective review of PLHIV who had corrected serum calcium of ≥10.5 mg/dL between 2010 and 2019. Demographic data, associated diseases, and treatment details were collected. Corrected serum calcium levels were compared among the causes of hypercalcemia.
A total of 70 of 2168 (3.2%) PLHIV had hypercalcemia. Forty-nine (70.0%) were male with a mean age of 47.7 ± 4.7 years. Only two (2.9%) had symptoms of hypercalcemia. Fifty-four patients had identifiable causes of hypercalcemia; 21 infections (30.0%), 17 solid organ malignancies (24.3%), 14 hematologic malignancies (20.0%), and two other specific causes (2.9%). Mean corrected serum calcium concentrations of PLHIV who had solid organ malignancy, hematologic malignancy, infection, and unknown causes were 12.8 ± 2.1, 11.4 ± 1.0, 11.2 ± 0.6, and 10.8 ± 0.2 mg/dL, respectively. Corrected serum calcium levels were significantly greater in patients who had solid organ malignancy comparing to those with other causes of hypercalcemia ( < 0.05, all). Logistic regression identified solid organ malignancy as the only factor associated with moderate to severe hypercalcemia (odds ratio 12.72, 95% confidence interval 3.11-52.08; < 0.001).
Hypercalcemia in PLHIV is associated with solid organ malignancy, hematologic malignancy, and infection. Most PLHIV with hypercalcemia are asymptomatic. Solid organ malignancy is associated with moderate to severe hypercalcemia, and as such PLHIV presenting with moderate to severe hypercalcemia should be investigated for solid organ malignancy.
高钙血症在 HIV 感染者（PLHIV）中并不常见。PLHIV 高钙血症的病因尚未得到很好的记录。因此，我们研究了 PLHIV 高钙血症的病因。
我们对 2010 年至 2019 年间校正血清钙≥10.5mg/dL 的 PLHIV 进行了回顾性研究。收集了人口统计学数据、相关疾病和治疗细节。比较了高钙血症病因之间的校正血清钙水平。
在 2168 例 PLHIV 中，共有 70 例（3.2%）发生高钙血症。其中 49 例（70.0%）为男性，平均年龄为 47.7±4.7 岁。仅有 2 例（2.9%）有高钙血症的症状。54 例患者有明确的高钙血症病因；21 例感染（30.0%）、17 例实体器官恶性肿瘤（24.3%）、14 例血液恶性肿瘤（20.0%）和 2 例其他特定病因（2.9%）。实体器官恶性肿瘤、血液恶性肿瘤、感染和不明原因所致 PLHIV 的校正血清钙浓度分别为 12.8±2.1、11.4±1.0、11.2±0.6 和 10.8±0.2mg/dL。与其他高钙血症病因相比，实体器官恶性肿瘤患者的校正血清钙水平显著升高（均<0.05）。Logistic 回归分析发现，实体器官恶性肿瘤是与中重度高钙血症相关的唯一因素（比值比 12.72，95%置信区间 3.11-52.08；<0.001）。
PLHIV 高钙血症与实体器官恶性肿瘤、血液恶性肿瘤和感染有关。大多数 PLHIV 高钙血症患者无症状。实体器官恶性肿瘤与中重度高钙血症相关，因此，出现中重度高钙血症的 PLHIV 应进行实体器官恶性肿瘤的检查。
