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Abstract：
BACKGROUND: People who inject drugs (PWID) and living with the human immunodeficiency virus (PLHIV) are at higher risk of suffering marked derangements in micronutrient levels, leading to poor disease and treatment outcomes. Consequently, this can be monitored by measuring key biomarkers, such as total circulating (serum) 25-hydroxycholecalciferol (25(OH)D3), calcium, and alkaline phosphatase (ALP) for timely intervention. Therefore, circulating levels of 25(OH)D3 and calcium, and ALP activity were determined in PWID and are highly active anti-retroviral treatment (HAART)-experienced or -naive, along with those without HIV infection.
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.
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.
摘要：
背景：注射毒品（PWID）和患有人类免疫缺陷病毒（PLHIV）的人在微量营养素水平上遭受明显紊乱的风险更高，导致不良的疾病和治疗结果。因此,这可以通过测量关键生物标志物来监测，例如总循环（血清）25-羟基胆钙化醇（25（OH）D3），钙，并对碱性磷酸酶(ALP)进行及时干预。因此,25(OH)D3和钙的循环水平，和ALP活性是在PWID中确定的，并且是经历过或幼稚的高活性抗逆转录病毒治疗（HAART），以及那些没有艾滋病毒感染的人。
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。
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。
