1110 - Severe Vitamin-D Deficiency in HIV-Infected Patients: Relationships with Inflammation, Bone Metabolism and Functional Status

Monday, November 7, 2011: 9:00 AM-6:00 PM
Hall F2 - Poster Hall (McCormick Place West)
Thiphaine Ansemant1, Paul Ornetti1, Christine Piroth1, Sophie Mahy2, Jean C. Guilland3, Laurence Duvillard3, Delphine Croisier2, Stephanie Ewing3, Christian Tavernier1, Pascal Chavanet2, Jean Francis Maillefert1 and Lionel Piroth2, 1Rheumatology, Dijon, France, 2Infectious diseases department, Dijon, France, 3INSERM U866 and laboratory of biochemistry, Dijon, France
Presentation Number: 1110

Background/Purpose: to assess the relationships between severe hypovitaminosis D (SHD) with lifestyle habits, comorbidities, HIV infection and antiretroviral history, and inflammation in HIV infected patients. 

Method: 263 unselected HIV infected outpatients consulting during spring 2010 were included in a cross sectional study. Apart from clinical examination, data on their medical history, food habits, sun exposure and addictions were collected. Fasting blood samples were taken for immunological, virological, inflammation, endocrine and bone evaluations.

Result: SHD (<10ng/ml) was found in 95 (36%) patients, and mild deficiency (10-30 ng/ml) in 135 (51%). In multivariate analysis, SHD was associated i) with mean daily sun exposure (OR +1 hour: 0.84, 95% CI: 0.74-0.94, p=0.03), current (OR: 2.63; CI95%: 1.27-5.45, p=0.009) or past (OR: 2.74; 95% CI: 1.17-6.43, p=0.02) smoking, Hepatitis C (OR: 1.87; 95% CI: 0.92-3.85, p=0.09) and B (OR: 2.76; CI95%:1.17-6.54, p=0.005) coinfections, functional status (OR for past history of fall: 1.80 95% CI: 1.00-3.27, p=0.02), and ii) with increased IL-6 levels (OR +1 pg/ml, 1.13, 95% CI: 1.02-1.25, p=0.02), and elevated C-Telopeptides X (CTX) (OR:2.44 95% CI: 1.23-4.81, p=0.01) .

Conclusion: SHD appears to be more closely associated with comorbidities and functional status than with the history of HIV infection and the therapies used. Certain antiretroviral drugs may have a negative impact, which could be counterbalanced by a positive impact on inflammation. Increased CTX reflects higher oscteoclastic activity and the risk of bone fracture, and underlines the need to improve functional status and the management of comorbidities, in addition to vitamin D supplementation.

Keywords: 25-hydroxyvitamin D, bone metabolism and inflammation

Disclosure: T. Ansemant, None; P. Ornetti, None; C. Piroth, None; S. Mahy, None; J. C. Guilland, None; L. Duvillard, None; D. Croisier, None; S. Ewing, None; C. Tavernier, None; P. Chavanet, None; J. F. Maillefert, None; L. Piroth, None.