HIV - 1 in 3 Low in Vitamin D

posted: 10/12/2008

Almost 1 in 3 people living with HIV have too little vitamin D, Dutch researchers report. African and other darker skinned people are most likely to be short of vitamin D. Among people with white skin, those on NNRTI-based treatment were more likely to be short of vitamin D than people taking protease inhibitors.

Vitamin D is important to good health. You need it for healthy bones and it plays an important role in the immune system. Vitamin D shortage among people with HIV is linked to low CD4 cell counts and worsening HIV disease.

The vitamin can be obtained from diet (but not much) and we get most vitamin D from sunlight on the skin. We tend to get less vitamin D in winter when the days are short and the colder weather means we keep more covered up.

Deficiencies in vitamin D can have a number of causes, including ageing, low exposure to sunlight, and poor diet. HIV itself can also affect levels of vitamin D. Protease inhibitors can reduce our ability to metabolise vitamin D.

1 in 3 found short of vitamin D

The Dutch investigators looked at vitamin D deficiency among 252 HIV-positive patients. They found almost 1 in 3 people with HIV have vitamin D deficiency.

Women were much more likely to be short of vitamin D than men, 58% for women compared with men’s 25%. This could not be due to the menopause because the women were too young.

People with darker skin colours experience more vitamin D shortage. Among white people 19 have too little vitamin D, but among people of Mediterranean origin it is 33%, 44% among Asian patients and 63% among African and other black patients.
 

1 in 4 people not on HIV treatments have too little vitamin D; slightly more people on treatments are short of vitamin D. People taking NNRTI were most likely to be short of the vitamin compared with people taking a protease inhibitor-based treatment (37% vs. 23%).

Shortage of vitamin is NOT because of poor diet or not sunbathing
There were no significant differences in diet or exposure to sunlight between the people with or without vitamin D deficiency. The only factor significantly associated with an increased risk of vitamin D deficiency is skin colour.

The researchers conclude, “adequate vitamin D is necessary for the maintenance of good bone mineral density. Therefore the vitamin D status of HIV-infected patients, especially those having a dark skin colour or receiving NNRTI- protease inhibitor-containing [antiretroviral therapy], should be evaluated” by measuring both 25-hydroxyvitamin D and levels of parathyroid hormone. “By doing so vitamin D deficiency could be detected early and treated.”

What can you do for yourself?

You can’t change your diet and expect to increase your vitamin D level enough. Getting out of doors and showing some skin, especially in winter, will help. But what this study is saying to people with HIV is 

• ask your GP or HIV clinic to run tests to check vitamin D level
• ask your GP about prescribing a vitamin supplement or an injection if your vitamin D level is low.

Here's medical advice on vitamin D. The GP can prescribe vitamin D, either as ergocalciferol or calciferol.

Source with reference
 

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