Vitamin D Deficiency and Insufficiency in HIV-infected Children and Young Adults

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.