Vitamin D Levels Rise with Supplementation in Women with HIV; No Effect on Inflammatory Markers
SAN FRANCISCO, CA—Women infected with HIV who receive vitamin D supplementation have increased vitamin D levels, but not improved inflammatory markers, results of a Chicago Women's Interagency HIV Study (WIHS) study reported at IDWeek 2013.
Furthermore, at 6-month follow-up, only 54% of women with insufficient vitamin D levels received prescriptions for this nutrient, even when their primary care providers were provided with results of vitamin D testing, noted Oluwatoyin Adeyemi, MD, Ruth M Rothstein CORE Center, Cook County Hospital and Rush University Medical Center, Chicago, IL, and colleagues.
“This likely reflects the lack of formal supplementation guidelines,” Dr. Adeyemi reported, who added that “data on the impact of vitamin D supplementation on inflammatory markers are sparse.”
The prospective observational study of 127 women who were HIV-positive was conducted at three Chicago WIHS sites in Chicago between 2010 and 2012. Vitamin D was measured at baseline. Patients with insufficient levels of vitamin D were given recommendations for supplementation, as were their primary care providers.
Demographic and clinical characteristics were compared among women with insufficient (<30ng/mL) vs. sufficient (≥30ng/mL) vitamin D at baseline using chi-squared tests for categorical and Wilcoxon rank sum tests for continuous variables. Logistic regression was used to identify factors associated with achieving sufficient vitamin D levels (≥30ng/mL) at 6 months. Changes in parathyroid hormone (PTH) and inflammatory markers (IL-6, hsCRP, and TNF-alpha) from baseline to 6 months were compared by supplementation status using Wilcoxon rank sum tests.
At baseline, 92 HIV-positive women (72%) had insufficient levels of vitamin D (median, 18ng/mL), which was found to be associated with younger median age (44.5 vs. 51 years; P<0.01), African-American race (82.6% vs. 68.6%; P=0.019), being HCV-negative (72.5% vs. 41.2%; P<0.01), and having a CD4 <500 (50% vs. 24%; P=0.019), Dr. Adeyemi reported.
“At 6 months, 54% of women with insufficient vitamin D had been prescribed vitamin D and 97% took prescribed vitamin D,” she added. “Vitamin D prescriptions were more common among older women (P=0.058), those on HAART (P=0.002) and those with undetectable HIV RNA (P<0.001).
At 6 months, 29% of the women achieved sufficient vitamin D levels. In multivariable analysis, this was associated with having a baseline visit in winter/spring vs. summer/fall (OR 26.4; 95% CI 2.25–310.6), taking vitamin D supplements (OR 15.8; 95% CI 2.9–85.1), use of tenofovir (OR 8.57; 95% CI 1.63–45.1) and use of an antidepressant (OR 4.97; 95% CI 1.16–21.3).
None of the changes between baseline and 6 months in vitamin D or inflammatory markers was statistically significant: PTH, P=0.798; IL-6, P=0.384; TNF-alpha, P=0.846; and HsCRP, P=0.440.