Effects of cholecalciferol supplementation on serum and urinary vitamin D metabolites and binding protein in HIV-infected youth. Issue 168 (April 2017)

• Record Type: Journal Article
• Authors: Eckard, Allison Ross; Thierry-Palmer, Myrtle; Silvestrov, Natalia; Rosebush, Julia C.; O'Riordan, Mary Ann; Daniels, Julie E.; Uribe-Leitz, Monika; Labbato, Danielle; Ruff, Joshua H.; Singh, Ravinder J.; Tangpricha, Vin; McComsey, Grace A.
• Is Part Of: Journal of steroid biochemistry and molecular biology. Issue 168(2017)
• Page Start: 38
• Page End: 48
• Publication Date: 2017-04
• Subjects: 1, 25(OH)2D3 1, 25-dihydroxycholecalciferol -- 1, 25(OH)2D 1, 25-dihydroxyvitamin D -- 24, 25(OH)2D3 24, 25-dihydroxycholecalciferol -- 24, 25(OH)2D 24, 25-dihydroxyvitamin D -- 25(OH)D3 25-hydroxycholecalciferol -- 25(OH)D 25-hydroxyvitamin D -- vitamin D3 cholecalciferol -- VDBP vitamin D binding protein -- PTH parathyroid hormone -- cART combination antiretroviral therapy (cART) -- EFV efavirenz -- NNRTI non-nucleoside reverse transcriptase inhibitor -- PI protease inhibitor -- NRTI nucleoside reverse transcriptase inhibitor -- RCT randomized-controlled trial -- CV coefficients of variance; HIV -- Vitamin d metabolites -- Vitamin d binding protein -- Cholecalciferol supplementation -- Randomized-controlled trial -- Pediatrics and adolescents -- Vitamin D; Steroid hormones -- Periodicals; Biochemistry -- Periodicals; Hormones -- Periodicals; Molecular Biology -- Periodicals; Hormones stéroïdes -- Périodiques; Steroid hormones; Periodicals; 572.579
• DOI: 10.1016/j.jsbmb.2017.01.018
• Languages: English
• ISSNs: 0960-0760

Abstract

Highlights: Cholecalciferol supplementation effectively raises serum 25-hydroxyvitamin D in the majority of HIV-infected youth. Changes in vitamin D metabolites are similar between HIV-infected youth and controls with cholecalciferol supplementation. High-dose cholecalciferol raises 25-hydroxyvitamin D in HIV-infected youth regardless of efavirenz use. Abstract: Vitamin D insufficiency is widespread in HIV-infected patients. HIV and/or antiretroviral therapy (ART), particularly efavirenz (EFV), may interfere with vitamin D metabolism. However, few data from randomized, controlled trials exist. Here, we investigate changes in vitamin D metabolites and binding protein (VDBP) after 6 months of supplementation in a randomized, active-control, double-blind trial investigating 2 different monthly cholecalciferol (vitamin D3 ) doses [60, 000 (medium) or 120, 000 (high) IU/month] vs. a control arm of 18, 000 IU/month in 8–25 year old HIV-infected youth on ART with HIV-1 RNA <1000 copies/mL and baseline 25-hydroxycholecalciferol (25(OH)D3 ) ≤30 ng/mL. A matched healthy uninfected group was enrolled in a similar parallel study for comparison. Changes after 6 months were analyzed as intent-to-treat within/between groups [control group (low dose) vs. combined supplementation doses (medium + high)]. At 6 months, 55% vs. 82% of subjects in control and supplementation groups, respectively, reached 25(OH)D3 ≥30 ng/mL (P = 0.01) with no difference between medium and high doses (both 82% ≥30 ng/mL). There were few differences for those on EFV vs. no-EFV, except serum VDBP decreased in EFV-treated subjects (both within- and between-groups P ≤ 0.01). There were no significant differences between the HIV-infected vs. healthy uninfected groups. The major finding of the present study is that cholecalciferol supplementation (60, 000 or 120, 000 IU/month) effectively raises serum 25(OH)D3 in the majority of HIV-infected subjects, regardless of EFV use. Notably, response to supplementation was similar to that of uninfected subjects.