Higher HIV Viral Load is associated with lower levels of …...Pontificia Universidad Católica de...
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Higher HIV Viral Load is associated with lower levels of vitamin D in Treatment-naive HIV patients Ceballos ME, MD 1 ; Fernandez P, RN 1 ; Carvajal C, RN 1 ; Dominguez A, MSc 2 ; Gonzalez G 3 . MD 1 Infectious Diseases Department. 2 Public Health Department. 3 Endocrinology Department . School of Medicine. Pontificia Universidad Católica de Chile TABLE 1. baseline Characteristics Characteristic HIV patients Controls N 61 22 Male N (%) 61 (100) 22 (100) Mean age (y/o), (range) 31 (19-50) 34 (19-51) Smokers N (%) 48 (78,7) NA Physical activity N (%) 27 (44,3) NA BMI (Kg/m²) 23,8 25 Winter/autumn season sampling (%) 57 54 Mean lymphocyte CD4 count (cells/mm 3 ) 365 -- CDC A stage (%) 85 -- VL ≥ 10 5 (copies/mL) 19 -- TABLE 2. Bone parameters Bone parameters HIV patients Controls Normal DXA z- score (> -2.0) (%) 79 -- Normal bone resorption (CTx < 0.58 ng/mL) N (%) 8 (87) -- Vitamin D deficiency (25 OHD < 20 ng/ml) (%) 68,3 45 Mean levels 25OHD (ng/ml) 17,3 ±6,6 20.9 ± 7.0 p=0.039 Mean levels 25OHD (ng/ml) regarding VL (copies/mL) VL > 10 5 : 14.9 ±6,1 VL<10 5 : 18,5 ±6,8 -- p =0.044 Session: 242 Presentation Number: 2187 Background: Bone loss and Vitamin D deficiency have been reported in HIV patients. Nutritional involvement, comorbidities and antiretroviral therapy could explain this association. However, independent effect of HIV on bone metabolism is less known. The objective of this study was to assess vitamin D deficiency and bone involvement in antiretroviral treatment-naive HIV patients. Methods: We studied newly diagnosed, treatment-naive, HIV patients, aged 18 to 50 years old. Exclusion criteria were: history of fragility bone fractures, bone metabolic disease or any secondary causes of osteoporosis. Dual energy x ray absorptiometry (DXA), fasting serum sample of 25OHD, CTx (bone resorption marker), PTH, TSH, testosterone, biochemical parameters, CD4 count and HIV viral load (VL) were measured. Variables such as body mass index (BMI), sunlight exposure, smoking, drug use, dairy intake, physical activity and season of sampling were analyzed. 25OHD levels of patients were compared with a control group (22 healthy volunteers) matched by age, sex and season of sampling. Student's t test with a significance level of 0.05 was employed. Results: Sixty one male patients, mean age 31 years old (19-50 y/o), BMI 23.8 kg/m2 were recruited from June 2014 to March 2016 (57% in winter/autumn season). Median CD4 count was 365 cells/mL (85% CDC stage A) and 19 patients had a VL ≥10⁵ copies/mL. Thirteen percent had abnormal DXA (z score < 2.0) ; CTx was higher than 0.584 ng/mL (upper normal value) in only one. Mean 25OHD was significantly lower in patients (17.3 ± SD 6.6 ng/mL) versus controls (20.9 ± SD 6.9 ng/mL), p= 0.039 (Fig 1). Vitamin D deficiency (25OHD < 20 ng/mL) was found in 68.3% of patients. Mean 25OHD in patients with VL > 10⁵ was 14.9 ng/mL (SD 6.1), while in patients with VL <10⁵, it was 18.9 ng/mL (SD 7.1) (p =0.044) (fig 2). No significant association was seen between 25OHD, DXA or CTx and other variables such as age, BMI, sunlight exposure, smoking, drug use, dairy intake and CDC stage. Conclusion: Our findings show that in treatment-naïve HIV patients, vitamin D deficiency is highly prevalent and greater that in healthy volunteers. Higher HIV viral load seems to induce lower levels of vitamin D. However, in these patients, bone involvement does not seem to be common. Bone loss and Vitamin D deficiency have been reported in HIV patients. Independent effect of HIV on bone metabolism is not well known. We aim to assess vitamin D deficiency and bone involvement in treatment-naive HIV patients. Dual-energy x-ray absorptiometry (DXA), 25OHD, CTx, PTH, TSH, testosterone, biochemical parameters, CD4 count and HIV viral load (VL) were measured. Variables such as body mass index (BMI), sunlight exposure, smoking, drug use, dairy intake, physical activity and season of sampling were analyzed. 25OHD levels of patients were compared with a control group (22 healthy volunteers) matched by age, sex and season of sampling. No significant association was seen between 25OHD, DXA or CTx and other variables such as age, BMI, sunlight exposure, smoking, drug use, dairy intake and CDC stage. Vitamin D deficiency is highly prevalent in treatment-naive HIV patients , and greater that in healthy volunteers. Higher HIV viral load seems to induce lower levels of vitamin D. However, in these patients, bone involvement does not seem to be common. Copyrights® 2016. Ceballos ME, Fernandez P, Carvajal C et al. Email: [email protected] ABSTRACT BACKGROUND METHODS Figure 1 Figure 2 CONCLUSIONS TABLE 1. Baseline Characteristics RESULTS TABLE 2. Bone parameters P=0.039 P=0.044
Transcript of Higher HIV Viral Load is associated with lower levels of …...Pontificia Universidad Católica de...
Higher HIV Viral Load is associated with lower levels of vitamin D in Treatment-naive HIV patients
Ceballos ME, MD1; Fernandez P, RN1; Carvajal C, RN1; Dominguez A, MSc2; Gonzalez G3. MD1Infectious Diseases Department. 2Public Health Department. 3Endocrinology Department . School of Medicine.
Pontificia Universidad Católica de Chile
TABLE 1. baseline Characteristics
Characteristic HIV patients Controls
N 61 22
Male N (%) 61 (100) 22 (100)
Mean age (y/o), (range) 31 (19-50) 34 (19-51)
Smokers N (%) 48 (78,7) NA
Physical activity N (%) 27 (44,3) NA
BMI (Kg/m²) 23,8 25
Winter/autumn seasonsampling (%)
57 54
Mean lymphocyte CD4 count (cells/mm3)
365 --
CDC A stage (%) 85 --
VL ≥ 105 (copies/mL) 19 --
TABLE 2. Bone parameters
Boneparameters
HIV patients Controls
Normal DXA z-score (> -2.0) (%)
79 --
Normal bone resorption(CTx < 0.58 ng/mL) N (%)
8 (87) --
Vitamin D deficiency(25 OHD < 20 ng/ml) (%)
68,3 45
Mean levels 25OHD (ng/ml)
17,3 ±6,6 20.9 ±7.0
p=0.039
Mean levels25OHD (ng/ml)regarding VL (copies/mL)
VL > 105:14.9 ±6,1
VL<105: 18,5 ±6,8
-- p =0.044
Session: 242Presentation Number:
2187
Background: Bone loss and Vitamin D deficiency have been reported in HIVpatients. Nutritional involvement, comorbidities and antiretroviral therapycould explain this association. However, independent effect of HIV on bonemetabolism is less known. The objective of this study was to assess vitamin Ddeficiency and bone involvement in antiretroviral treatment-naive HIVpatients.
Methods: We studied newly diagnosed, treatment-naive, HIV patients, aged18 to 50 years old. Exclusion criteria were: history of fragility bone fractures,bone metabolic disease or any secondary causes of osteoporosis. Dual energyx ray absorptiometry (DXA), fasting serum sample of 25OHD, CTx (boneresorption marker), PTH, TSH, testosterone, biochemical parameters, CD4count and HIV viral load (VL) were measured. Variables such as body massindex (BMI), sunlight exposure, smoking, drug use, dairy intake, physicalactivity and season of sampling were analyzed. 25OHD levels of patients werecompared with a control group (22 healthy volunteers) matched by age, sexand season of sampling. Student's t test with a significance level of 0.05 wasemployed.
Results: Sixty one male patients, mean age 31 years old (19-50 y/o), BMI 23.8kg/m2 were recruited from June 2014 to March 2016 (57% in winter/autumnseason). Median CD4 count was 365 cells/mL (85% CDC stage A) and 19patients had a VL ≥10⁵ copies/mL. Thirteen percent had abnormal DXA (zscore < 2.0) ; CTx was higher than 0.584 ng/mL (upper normal value) in onlyone. Mean 25OHD was significantly lower in patients (17.3 ± SD 6.6 ng/mL)versus controls (20.9 ± SD 6.9 ng/mL), p= 0.039 (Fig 1). Vitamin D deficiency(25OHD < 20 ng/mL) was found in 68.3% of patients. Mean 25OHD in patientswith VL > 10⁵ was 14.9 ng/mL (SD 6.1), while in patients with VL <10⁵, it was18.9 ng/mL (SD 7.1) (p =0.044) (fig 2). No significant association was seenbetween 25OHD, DXA or CTx and other variables such as age, BMI, sunlightexposure, smoking, drug use, dairy intake and CDC stage.
Conclusion: Our findings show that in treatment-naïve HIV patients, vitamin Ddeficiency is highly prevalent and greater that in healthy volunteers. HigherHIV viral load seems to induce lower levels of vitamin D. However, in thesepatients, bone involvement does not seem to be common.
Bone loss and Vitamin D deficiency have been reported in HIV patients.
Independent effect of HIV on bone metabolism is not well known. We aim to assess vitamin D deficiency and bone involvement in treatment-naive HIV patients.
Dual-energy x-ray absorptiometry (DXA), 25OHD,CTx, PTH, TSH, testosterone, biochemicalparameters, CD4 count and HIV viral load (VL) weremeasured.
Variables such as body mass index (BMI), sunlightexposure, smoking, drug use, dairy intake, physicalactivity and season of sampling were analyzed.25OHD levels of patients were compared with acontrol group (22 healthy volunteers) matched by
age, sex and season of sampling.
No significant association was seen between 25OHD, DXA or CTxand other variables such as age, BMI, sunlight exposure, smoking,
drug use, dairy intake and CDC stage.
Vitamin D deficiency is highly prevalent in treatment-naive HIV patients , and greater that in healthy volunteers. Higher HIV viral load seems to induce lower levels of vitamin D. However, in these patients, bone involvement does not seem to be common.
Copyrights® 2016. Ceballos ME, Fernandez P, Carvajal C et al. Email: [email protected]
ABSTRACT
BACKGROUND
METHODS
Figure 1
Figure 2
CONCLUSIONS
TABLE 1. Baseline Characteristics
RESULTS
TABLE 2. Bone parameters
P=0.039
P=0.044
