Liver-Related Factors Associated with Low Vitamin D Levels in HIV and HIV/HCV Coinfected Patients and Comparison to General Population

Author(s): Laura Milazzo, Cristina Mazzali, Giovanna Bestetti, Erika Longhi, Antonella Foschi, Anita Viola, Tarcisio Vago, Massimo Galli, Carlo Parravicini, Spinello Antinori.

Journal Name: Current HIV Research

Volume 9 , Issue 3 , 2011

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Abstract:

Objectives: Low 25-Hydroxyvitamin D (25[OH]D) was associated with severe fibrosis and low sustained virological response (SVR) after interferon (IFN)-based therapy in chronic hepatitis C. Furthermore, hypovitaminosis D was reported in HIV-infected individuals, but its role in liver disease progression in HIV/HCV coinfection is unknown.

Methods: 25(OH)D was retrospectively measured in 237 HIV-infected patients (93 with HCV coinfection) and 76 healthy controls. Multivariate analysis included season, immuno-virological data, combined antiretroviral therapy (cART) and, in a subgroup of 51 HIV/HCV-genotype 1 coinfected patients, factors influencing SVR to pegylated-IFN and ribavirin. In a group of 20 patients, liver expression of cytochrome (CY)-P27A1 and CYP2R1, 25-hydroxylating enzymes, was assessed by immunohistochemistry.

Results: Median 25(OH)D levels were 23.4 (interquartile range 16.7-33.7) ng/mL in the HIV-infected population and 24 ng/mL (18.3-29.5) in healthy controls (p=0.9). At multiple regression analysis, only winter/spring measurements correlated with lower 25(OH)D levels. No correlation with HCV coinfection, nor with cART regimens was found. Low 25(OH)D was independently associated with advanced fibrosis in HIV/HCV coinfected patients (p=0.023), whereas no association emerged with SVR to IFN-based therapy. CYP27A1 and CYP2R1 expression was associated neither with 25(OH)D serum levels nor with HCV-infection, liver histology, or cART.

Conclusions: In our experience, despite the high prevalence of 25(OH)D insufficiency, HIV and HCV-infection did not seem to influence vitamin D status. The role of HIV, HCV and cART on hypovitaminosis D needs further validation in larger cohorts that account for the vitamin levels in general populations and for seasonal and regional variability.

Keywords: CYP27A1, CYP2R1, 25-hydroxyvitamin D insufficiency, HIV, HIV/HCV coinfection, liver fibrosis, Immunohistochemistry, SVR

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Article Details

VOLUME: 9
ISSUE: 3
Year: 2011
Page: [186 - 193]
Pages: 8
DOI: 10.2174/157016211795945269
Price: $58

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