Vitamin D deficiency in HIV-infected postmenopausal Hispanic and African-American women

Abstract

We evaluated vitamin D status in HIV+ and HIV- postmenopausal African-American (AA) and Hispanic women. Most women (74-78%) had insufficient 25-hydroxyvitamin D (25OHD) levels, regardless of HIV status. 25OHD was lower in AA women and women lacking supplement use, providing support for screening and supplementation. Among HIV+ women, 25OHD was associated with current CD4 but not type of antiretroviral therapy.

Introduction: To evaluate vitamin D status and factors associated with vitamin D deficiency and insufficiency in HIV-infected (HIV+) postmenopausal minority women.

Methods: In this cross-sectional study, 89 HIV+ and 95 HIV- postmenopausal women (33% AA and 67% Hispanic) underwent assessment of 25OHD, 1,25-dihydroxyvitamin D, parathyroid hormone, markers of bone turnover and bone mineral density by dual energy X-ray absorptiometry.

Results: The prevalence of low 25OHD did not differ by HIV status; the majority of both HIV+ and HIV- women (74-78%) had insufficient levels (<30 ng/ml). Regardless of HIV status, 25OHD was significantly lower in AA subjects, and higher in subjects who used both calcium and multivitamins. In HIV+ women on antiretroviral therapy (ART), 25OHD was directly associated with current CD4 count (r=0.32; p<0.01) independent of age, ethnicity, BMI, or history of AIDS-defining illness. No association was observed between 1,25(OH)(2)D and CD4 count or between serum 25OHD, 1,25(OH)(2)D or PTH and type of ART.

Conclusions: In postmenopausal minority women, vitamin D deficiency was highly prevalent and associated with AA race and lack of supplement use, as well as lower current CD4 cell count. These results provide support for screening and repletion of vitamin D in HIV+ patients.

Fig. 1

Prevalence of vitamin D insufficiency and deficiency in HIV− (open bars) and HIV+ (filled bars) postmenopausal women

Fig. 2

Serum 25OHD levels (mean±SE) in HIV+ and HIV− women according to race/ethnicity: Hispanic (open bars) and African-American (filled bars); **p<0.01

Fig. 3

Proportion of HIV+ and HIV− postmeonpausal women with serum 25OHD levels <30 ng/ml according to self-reported supplementation at the baseline evaluation *p<0.05 compared to group without supplementation

Fig. 4

Association between serum 25OHD and current CD4 count in HIV+ postmenopausal women currently taking antiretroviral therapy (N=68; r=0.32, p<0.01). Hispanic subjects are represented by filled circles, AA subjects by open circles