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.

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“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.