Hypovitaminosis D in pacific northwest HIV-infected patients on antiretroviral therapy

摘要

To the Editor: The risk of hypovitaminosis D in antiretroviral-treated patients living in northern climes is underreported.1 In this observational, cross-sectional cohort study of 122 human immunodeficiency-virus (HIV)-infected outpatients in Portland, Oregon between March and October 2011, we compared vitamin D levels stratified by the use of Atripla (efavirenz, tenofovir, and emtricitabine), non-Atripla antire-trovkal therapy (ART) regimens, and multivitamins (600-1000 IU vitamin D). After Providence Health Systems institutional review board approval, patients' demographics (age, sex, race, weight, height, and body mass index [BMI]) and laboratory parameters (complete blood count, metabolic panel, CD4, and quantitative HIV RNA polymerase chain reaction) were extracted from the electronic medical records. Serum 25[OH]D was measured by chemiluminescent immunoassay. Vitamin D status was defined according to 25[OH]D level as severely deficient (<10 ng/mL), deficient (10-20 ng/mL), insufficient (20-30 ng/mL), or optimal (>30 ng/mL). Antiretroviral therapy regimens consisted of the following: A, Atripla (n = 56); B, Truvada (tenofovir and emtricitabine) plus other ART (n = 35); C, other ART (n = 18); and no ART drugs (n = 13). All patients receiving regimen C had previously failed or were intolerant to regimens A and/or B. Descriptive statistics were used to characterize populations and summarize results. Frequencies and proportions described dichotomous and categorical variables, whereas means and standard deviations described continuous variables.