Al Ameen Journal of Medical Sciences (Jan 2024)
Prevalence of vitamin D deficiency in PLHIV and its relation to CD4 count and ART: A cross sectional study
Abstract
Introduction: HIV (Human Immunodeficiency Virus) continues to be a major global public health issue with no cure. Vitamin D is a fat-soluble hormone that is majorly involved in the classical function of calcium and phosphorus hemostasis and bone mineralization as well as non-classical functions of immune modulation in various viral and autoimmune diseases. A combination of both traditional risk factors, HIV- specific and antiretroviral therapy (ART)-specific contributors leave HIV-infected persons (PLHIV) at a greater risk for low 25-OH-Vitamin D levels and frank vitamin D deficiency. Aims and Setting: The current study was conducted to assess and characterize the prevalence of Vitamin D deficiency in PLHIV-on-ART attending a tertiary care hospital and assess the factors that may be affecting it. Methods: 95 PLHIV registered at an ART center were selected over a period of 6 months based on Inclusion and Exclusion criteria. Flow cytometry estimation of CD4 count and ELISA based quantitative assessment of serum 25-OH Vitamin D3 were done along with detailed clinical examination. P<0.05 was considered to be statistically significant. Results: About half of the PLHIV assessed were deficient in vitamin D. Severe vitamin D deficiency was noted in one-fourth of subjects. Serum vitamin D levels were significantly less in subjects on ZLN regime compared to TLE regime. No significant difference was found between vitamin D deficiency and duration of treatment, different treatment regimens or differing CD4 counts. No significant association of serum levels of Vitamin D with duration of treatment or varying CD4 count was found. Conclusion: There is greater prevalence of subnormal levels of Vitamin D in PLHIV on ART. ZLN regime appears to have a negative impact on Vitamin D levels in comparison to TLE regimen. More research needs to be done to further evaluate the physiology of Vitamin D in PLHIV on ART.