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.
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.