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Home >> Publications >> Vitamin D deficiency and its relation to bone mineral density and liver fibrosis in HIV-HCV coinfection.

Publication

Author(s):

El-Maouche D, Mehta SH, Sutcliffe CG, Higgins Y, Torbenson MS, Moore RD, Thomas DL, Sulkowski MS, Brown TT.

Pub Title:

Vitamin D deficiency and its relation to bone mineral density and liver fibrosis in HIV-HCV coinfection.

Pub Date:

Aug 31 2012

Journal Issue:

Epub

Page Number:
Epub

Journal:

Title: 
Antivrial Therapy
Link: 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3790468/?report=classic

PubMed: 22910231
Pub PDF:

Abstract
BACKGROUND
: Fractures and cirrhosis are major causes of morbidity and mortality among HIV-HCV-coinfected individuals. It is not known whether vitamin D deficiency is associated with these outcomes.

METHODS: Between 2005 and 2007, 116 HIV-HCV-coinfected individuals underwent dual-energy X-ray absorptiometry within 1 year of a liver biopsy. 25-Hydroxyvitamin D (25OHD) and parathyroid hormone were measured from archived samples. Low bone mineral density (BMD) was defined as BMD≥2 standard deviations lower than age-, sex- and race-matched controls (Z-score ≤-2.0) at the total hip, femoral neck or lumbar spine. Histological fibrosis staging was assessed according to the METAVIR system (0 [no fibrosis] to 4 [cirrhosis]).

RESULTS: The cohort was 87% African-American and 63% male. The median age (IQR) was 49.9 years (46.5-53.3). A total of 89% had a CD4(+) T-cell count >200 cells/mm(3) and 64% were receiving HAART. The median 25OHD was 19 ng/ml (IQR 11.0-26.0). Hypovitaminosis D (25OHD≤15 ng/ml) was present in 41% and secondary hyperparathyroidism, defined by parathyroid hormone >65 pg/ml, was present in 24%. In total, 27% had low BMD (Z-score ≤-2) at the spine, femoral neck or total hip, and 39% had significant hepatic fibrosis (METAVIR≥2). In multivariate analysis, vitamin D deficiency was not associated with significant fibrosis or with BMD at any site.

CONCLUSIONS: Vitamin D deficiency was highly prevalent in this mostly African-American HIV-HCV-coinfected population, but was not related to BMD or liver disease severity. These data suggest that efforts to increase vitamin D levels in this population may not improve bone or liver outcomes.

PMID: 22910231 [PubMed - indexed for MEDLINE]

PMCID: PMC3790468

 

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Citation:

El-Maouche D, Mehta SH, Sutcliffe CG, Higgins Y, Torbenson MS, Moore RD, Thomas DL, Sulkowski MS, Brown TT. Vitamin D deficiency and its relation to bone mineral density and liver fibrosis in HIV-HCV coinfection. Antivir Ther. 2013;18(2):237-42. doi: 10.3851/IMP2264. Epub 2012 Aug 7. PubMed PMID: 22910231; PubMed Central PMCID: PMC3790468.