April 15, 2013

Vitamin D deficiency common, not linked to BMD, liver disease in HIV/HCV coinfection

El-Maouche D. Antivir Ther. 2013;18:237-242.

April 11, 2013

African-American patients coinfected with HIV and HCV often are vitamin D-deficient, but this condition had no impact on bone mineral density or severity of liver disease, according to recent results.

Researchers evaluated 116 patients coinfected with HIV and HCV who underwent bone mineral density (BMD) measurement— between January 2007 and February 2009 — less than 1 year after liver biopsy. The cohort (median age, 49.9 years; 63% men) was predominantly African-American (87%). Levels of 25-hydroxyvitamin D (25OHD) and parathyroid hormone were measured in each case.

The cohort had a median 25OHD level of 19 ng/mL; 41% of patients showed deficiencies (15 ng/mL or lower). Twenty-four percent of participants had hyperparathyroidism (parathyroid hormone levels greater than 65 pg/mL). Low BMD at the lumbar spine, total hip or femoral neck was observed in 27% of patients. Thirty-nine percent of patients had METAVIR scores of 2 or greater at biopsy, indicating significant hepatic fibrosis.

Low BMD was observed at similar rates among those with (30% of cases) and without vitamin D deficiency (25%; P=.57 for difference), as well as among those with (32% of cases) and without (25%) hyperparathyroidism (P=.46). Significant fibrosis also was observed similarly regardless of vitamin D deficiency or parathyroid hormone levels.

No significant associations were observed between 25OHD deficiency and either BMD at any evaluated site or fibrosis. Redefining vitamin D deficiency as either 20 ng/mL and lower or 10 ng/mL and lower did not significantly alter these results.

“Vitamin D deficiency was prevalent among predominantly African-American, HIV-HCV-coinfected individuals, but was not related to BMD or fibrosis,” the researchers wrote. “It is questionable whether vitamin D supplementation in such populations would provide any benefits, and whether African-Americans have vitamin D thresholds different from Caucasians. Further studies examining the effect of vitamin D supplementations in African-Americans with multiple comorbidities should assess potential benefits or harms of vitamin D replacement.”

Disclosure: See the study for a full list of relevant disclosures.


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