Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina, Departamento de Dermatologia, São Paulo, SP, Brazil; Centro de Referência em IST/AIDS, São Paulo, SP, Brazil.
Centro de Referência em IST/AIDS, São Paulo, SP, Brazil.
Braz J Infect Dis. 2021 May-Jun;25(3):101598. doi: 10.1016/j.bjid.2021.101598. Epub 2021 Jul 16.
Hypovitaminosis D is now considered a pandemic, especially among more vulnerable populations and in HIV-infected subjects, with 80% presenting levels below 30 ng/mL. As there is no consensus on the more adequate dosage needed to correct such deficiency, the objective of this study was to evaluate 25 (OH) vitamin D supplementation in HIV-1 patients deficient of vitamin D. A total of 73 HIV-1-infected patients were included, drawn from a cohort of 435 patients; 37 patients were randomized to the active group, supplemented once a week with 50,000 UI vitamin D by mouth (group 1) and 36 to the placebo group (group 2). The study period ranged from June 2016 to September 2017. Variables involved in vitamin D metabolism and risk factors associated with hypovitaminosis were evaluated. The mean age was 45 years and 31.5 % were women. Vitamin D supplementation was effective in normalizing serum levels after six months in group 1 (mean 35 ng/mL compared to 21 ng/mL for the placebo group; p = 0.04). No patient reached blood levels considered toxic (>100 UI). Efavirenz use can negatively influence vitamin D levels and supplementation is necessary as a likely adjunct to improving CD4+ T cells, resulting in greater effectiveness of the treatment. A weekly oral dose of 50,000 IU of vitamin D was sufficient to normalize the vitamin deficiency, safely and with good adherence among persons living with HIV/AIDS in Brazil.
维生素 D 缺乏症现在被认为是一种大流行病,尤其是在弱势群体和 HIV 感染者中,其中 80%的人血清 25(OH)D 水平低于 30ng/ml。由于对于纠正这种缺乏所需的更合适剂量尚未达成共识,本研究旨在评估 HIV-1 患者维生素 D 缺乏症的 25(OH)D 补充。共纳入了 73 例 HIV-1 感染患者,他们来自 435 例患者的队列;37 例患者被随机分为活性组,每周口服 50000IU 维生素 D 一次(第 1 组),36 例为安慰剂组(第 2 组)。研究时间从 2016 年 6 月到 2017 年 9 月。评估了维生素 D 代谢相关的变量和与维生素 D 缺乏相关的危险因素。平均年龄为 45 岁,31.5%为女性。第 1 组在 6 个月后血清水平恢复正常(平均 35ng/ml,安慰剂组为 21ng/ml;p=0.04)。没有患者达到被认为有毒的血液水平(>100UI)。依非韦伦的使用会对维生素 D 水平产生负面影响,因此需要补充维生素 D,可能有助于改善 CD4+T 细胞,从而提高治疗效果。每周口服 50000IU 维生素 D 是安全的,且巴西 HIV/AIDS 患者的依从性良好,足以使维生素缺乏正常化。