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Vitamin D deficiency and insufficiency in HIV-infected children and young adults
Candice Meyzer1, Pierre Frange, Hélène Chappuy
1From the *Unité de Recherche Clinique Paris Centre, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris; †CIC P0901 Mère Enfant, Inserm, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris, Université Paris Descartes; ‡EA3620, Université Paris Descartes, Sorbonne Paris-Cité; §Unité d'Immunologie et Hématologie Pédiatriques; ¶Urgences Pédiatriques, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris; ‖Laboratoire d'Ethique Médicale, Université Paris Descartes, Paris; **Centre d'Examens de Santé de la Caisse Primaire d'Assurance Maladie de la Seine-Saint-Denis, Bobigny; ††Service d'Explorations Fonctionnelles, Hôpital Necker Enfants Malades, Assistance Publique Hôpitaux de Paris; ‡‡INSERM U845, équipe Homéostasie du Phosphate, Université Paris Descartes; §§Pharmacologie, Groupe Hospitalier Broca Cochin Hôtel Dieu; and ¶¶Service de Physiologie et Explorations Fonctionnelles, Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, Paris, France.J.-M.T. and M.C. contributed equally to the study.
Background:
Vitamin D insufficiency and HIV infection are both risk factors for chronic disorders, so it is important to consider vitamin D status in HIV-infected patients.
Methods:
We prospectively investigated serum 25-hydroxyvitamin D (25(OH)D) concentrations, determined by radioimmunoassay, in 113 HIV-infected children (age≤24 years) and 54 healthy controls matched for age and phototype. We assessed the prevalence of vitamin D deficiency and insufficiency (VDD and VDI) defined as 25(OH)D titers of <10 ng/mL and between 10 and 30 ng/mL, respectively, and their predictive factors.
Results:
The overall prevalence of VDD and VDI was 38.9% and 58.7%, respectively. Mean serum 25(OH)D concentrations were significantly higher in the HIV group than the control group (14.2±6.9 ng/mL vs. 10.4±5 ng/mL, P<0.001). Variables significantly associated with low serum 25(OH)D concentrations in HIV-infected children were dark phototype (P<0.001) and age (r=-0.19, P=0.03). Patients receiving efavirenz had a trend toward lower serum 25(OH)D concentrations (11.1±4.6 ng/mL vs. 14.6±7 ng/mL, P=0.1). Dark phototype was the only independent risk factor for VDD in HIV-infected children (odds ratio=14.6; 95% confidence interval: 2.4-89.9, P=0.004).
Conclusions:
VDD and VDI were common in both HIV-infected and control groups, and serum 25(OH)D concentrations were significantly lower in controls than in HIV-infected children.
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