METHODS: This cross-sectional study compared serum concentrations of 25(OH)D3, calcium, and ALP in Kenyan PLHIV and were HAART-naive (n = 30) or -experienced (n = 61), PWID and without HIV (n = 132).
RESULTS: Circulating 25(OH)D3 levels were significantly different amongst the study groups (P < 0.001), and were significantly lower in the HAART-experienced (median, 17.3; IQR, 18.3 ng/ml; P < 0.001) and -naive participants (median, 21.7; IQR, 12.8 ng/ml; P = 0.015) relative to uninfected (median, 25.6; IQR, 6.8 ng/ml) PWID. In addition, the proportions of vitamin D deficiency (55.7%, 40.0%, and 17.4%) and insufficiency (31.1%, 53.3%, and 63.6%) compared to sufficiency (13.1%, 6.7%, and 18.9%; P < 0.001) were greater amongst HAART-experienced, -naive, and uninfected study groups, respectively. Likewise, serum total calcium concentrations were lower in the HAART-experienced relative to HIV-negative (P = 0.019) individuals. Serum ALP activity was also lower in the HAART-experienced in contrast to HIV-negative PWID (P = 0.048). Regression analysis indicated that predictors of circulating 25(OH)D3 were: age (β = 0.287; R2 = 8.0%; P = 0.017) and serum ALP (β = 0.283; R2 = 6.4%; P = 0.033) in the HAART-experienced PWID, and serum ALP (β = 0.386; R2 = 14.5%; P < 0.001) in the HIV-negative PWID.
CONCLUSIONS: This study suggests that HIV-1 infection and HAART, including injection substance use, decrease circulating 25(OH)D3, calcium and ALP activity. In addition, age and ALP activity are associated with low circulating vitamin D levels in HAART-experienced PWID. The results highlight the importance of incorporating vitamin D and calcium supplementation in treatment and rehabilitation protocols for PLHIV.
方法:本横断面研究比较了血清25(OH)D3、钙、和ALP在肯尼亚PLHIV和HAART-naive(n=30)或-经验(n=61),PWID和无HIV(n=132)。
结果:循环25(OH)D3水平在研究组之间存在显着差异(P<0.001),并且在经历HAART的人群中显著较低(中位数,17.3;IQR,18.3ng/ml;P<0.001)和-天真的参与者(中位数,21.7;IQR,12.8ng/ml;P=0.015)相对于未感染(中位数,25.6;IQR,6.8ng/ml)PWID。此外,维生素D缺乏的比例(55.7%,40.0%,和17.4%)和不足(31.1%,53.3%,和63.6%)与充足性(13.1%,6.7%,18.9%;P<0.001)在有HAART经验的人群中更高,-天真的,和未感染的研究小组,分别。同样,与HIV阴性个体相比,HAART患者的血清总钙浓度较低(P=0.019).与HIV阴性PWID相比,HAART中的血清ALP活性也较低(P=0.048)。回归分析表明,在有HAART经验的PWID中,循环25(OH)D3的预测因子为:年龄(β=0.287;R2=8.0%;P=0.017)和血清ALP(β=0.283;R2=6.4%;P=0.033)。在HIV阴性的PWID中,血清ALP(β=0.386;R2=14.5%;P<0.001)。
结论:这项研究表明,HIV-1感染和HAART,包括注射物质的使用,降低循环25(OH)D3、钙和ALP活性。此外,在有HAART经验的PWID中,年龄和ALP活性与低循环维生素D水平相关.结果强调了在PLHIV的治疗和康复方案中加入维生素D和钙补充剂的重要性。