Vitamin D deiciency and its relation to bone mineral density and liver ibrosis in HIV-HCV coinfection

Diala El-Maouche, Shruti H. Mehta, Catherine G. Sutcliffe, Yvonne Higgins, Michael Torbenson, Richard D. Moore, David L. Thomas, Mark S. Sulkowski, Todd T. Brown

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: Fractures and cirrhosis are major causes of morbidity and mortality among HIV-HCV-coinfected individuals. It is not known whether vitamin D deiciency is associated with these outcomes. Methods: Between 2005 and 2007, 116 HIV-HCVcoinfected individuals underwent dual-energy X-ray absorptiometry within 1 year of a liver biopsy. 25-Hydroxyvitamin D (25OHD) and parathyroid hormone were measured from archived samples. Low bone mineral density (BMD) was deined as BMD=2 standard deviations lower than age-, sex- and race-matched controls (Z-score =-2.0) at the total hip, femoral neck or lumbar spine. Histological ibrosis staging was assessed according to the METAVIR system (0 [no ibrosis] to 4 [cirrhosis]). Results: The cohort was 87% African-American and 63% male. The median age (IQR) was 49.9 years (46.5-53.3). A total of 89% had a CD4+ T-cell count <200 cells/mm3 and 64% were receiving HAART. The median 25OHD was 19 ng/ ml (IQR 11.0-26.0). Hypovitaminosis D (25OHD=15 ng/ml) was present in 41% and secondary hyperparathyroidism, deined by parathyroid hormone <65 pg/ml, was present in 24%. In total, 27% had low BMD (Z-score -2) at the spine, femoral neck or total hip, and 39% had signiicant hepatic ibrosis (METAVIR=2). In multivariate analysis, vitamin D deiciency was not associated with signiicant ibrosis or with BMD at any site. Conclusions: Vitamin D deiciency was highly prevalent in this mostly African-American HIV-HCV-coinfected population, but was not related to BMD or liver disease severity. These data suggest that efforts to increase vitamin D levels in this population may not improve bone or liver outcomes.

Original languageEnglish (US)
Pages (from-to)237-242
Number of pages6
JournalAntiviral Therapy
Volume18
Issue number2
DOIs
StatePublished - Apr 5 2013
Externally publishedYes

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Coinfection
Vitamin D
Bone Density
HIV
Liver
Femur Neck
Parathyroid Hormone
African Americans
Hip
Spine
Fibrosis
Secondary Hyperparathyroidism
Highly Active Antiretroviral Therapy
Photon Absorptiometry
CD4 Lymphocyte Count
Population
Liver Diseases
Multivariate Analysis
Morbidity
T-Lymphocytes

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

El-Maouche, D., Mehta, S. H., Sutcliffe, C. G., Higgins, Y., Torbenson, M., Moore, R. D., ... Brown, T. T. (2013). Vitamin D deiciency and its relation to bone mineral density and liver ibrosis in HIV-HCV coinfection. Antiviral Therapy, 18(2), 237-242. https://doi.org/10.3851/IMP2264

Vitamin D deiciency and its relation to bone mineral density and liver ibrosis in HIV-HCV coinfection. / El-Maouche, Diala; Mehta, Shruti H.; Sutcliffe, Catherine G.; Higgins, Yvonne; Torbenson, Michael; Moore, Richard D.; Thomas, David L.; Sulkowski, Mark S.; Brown, Todd T.

In: Antiviral Therapy, Vol. 18, No. 2, 05.04.2013, p. 237-242.

Research output: Contribution to journalArticle

El-Maouche, D, Mehta, SH, Sutcliffe, CG, Higgins, Y, Torbenson, M, Moore, RD, Thomas, DL, Sulkowski, MS & Brown, TT 2013, 'Vitamin D deiciency and its relation to bone mineral density and liver ibrosis in HIV-HCV coinfection', Antiviral Therapy, vol. 18, no. 2, pp. 237-242. https://doi.org/10.3851/IMP2264
El-Maouche, Diala ; Mehta, Shruti H. ; Sutcliffe, Catherine G. ; Higgins, Yvonne ; Torbenson, Michael ; Moore, Richard D. ; Thomas, David L. ; Sulkowski, Mark S. ; Brown, Todd T. / Vitamin D deiciency and its relation to bone mineral density and liver ibrosis in HIV-HCV coinfection. In: Antiviral Therapy. 2013 ; Vol. 18, No. 2. pp. 237-242.
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abstract = "Background: Fractures and cirrhosis are major causes of morbidity and mortality among HIV-HCV-coinfected individuals. It is not known whether vitamin D deiciency is associated with these outcomes. Methods: Between 2005 and 2007, 116 HIV-HCVcoinfected individuals underwent dual-energy X-ray absorptiometry within 1 year of a liver biopsy. 25-Hydroxyvitamin D (25OHD) and parathyroid hormone were measured from archived samples. Low bone mineral density (BMD) was deined as BMD=2 standard deviations lower than age-, sex- and race-matched controls (Z-score =-2.0) at the total hip, femoral neck or lumbar spine. Histological ibrosis staging was assessed according to the METAVIR system (0 [no ibrosis] to 4 [cirrhosis]). Results: The cohort was 87{\%} African-American and 63{\%} male. The median age (IQR) was 49.9 years (46.5-53.3). A total of 89{\%} had a CD4+ T-cell count <200 cells/mm3 and 64{\%} were receiving HAART. The median 25OHD was 19 ng/ ml (IQR 11.0-26.0). Hypovitaminosis D (25OHD=15 ng/ml) was present in 41{\%} and secondary hyperparathyroidism, deined by parathyroid hormone <65 pg/ml, was present in 24{\%}. In total, 27{\%} had low BMD (Z-score -2) at the spine, femoral neck or total hip, and 39{\%} had signiicant hepatic ibrosis (METAVIR=2). In multivariate analysis, vitamin D deiciency was not associated with signiicant ibrosis or with BMD at any site. Conclusions: Vitamin D deiciency was highly prevalent in this mostly African-American HIV-HCV-coinfected population, but was not related to BMD or liver disease severity. These data suggest that efforts to increase vitamin D levels in this population may not improve bone or liver outcomes.",
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T1 - Vitamin D deiciency and its relation to bone mineral density and liver ibrosis in HIV-HCV coinfection

AU - El-Maouche, Diala

AU - Mehta, Shruti H.

AU - Sutcliffe, Catherine G.

AU - Higgins, Yvonne

AU - Torbenson, Michael

AU - Moore, Richard D.

AU - Thomas, David L.

AU - Sulkowski, Mark S.

AU - Brown, Todd T.

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N2 - Background: Fractures and cirrhosis are major causes of morbidity and mortality among HIV-HCV-coinfected individuals. It is not known whether vitamin D deiciency is associated with these outcomes. Methods: Between 2005 and 2007, 116 HIV-HCVcoinfected individuals underwent dual-energy X-ray absorptiometry within 1 year of a liver biopsy. 25-Hydroxyvitamin D (25OHD) and parathyroid hormone were measured from archived samples. Low bone mineral density (BMD) was deined as BMD=2 standard deviations lower than age-, sex- and race-matched controls (Z-score =-2.0) at the total hip, femoral neck or lumbar spine. Histological ibrosis staging was assessed according to the METAVIR system (0 [no ibrosis] to 4 [cirrhosis]). Results: The cohort was 87% African-American and 63% male. The median age (IQR) was 49.9 years (46.5-53.3). A total of 89% had a CD4+ T-cell count <200 cells/mm3 and 64% were receiving HAART. The median 25OHD was 19 ng/ ml (IQR 11.0-26.0). Hypovitaminosis D (25OHD=15 ng/ml) was present in 41% and secondary hyperparathyroidism, deined by parathyroid hormone <65 pg/ml, was present in 24%. In total, 27% had low BMD (Z-score -2) at the spine, femoral neck or total hip, and 39% had signiicant hepatic ibrosis (METAVIR=2). In multivariate analysis, vitamin D deiciency was not associated with signiicant ibrosis or with BMD at any site. Conclusions: Vitamin D deiciency was highly prevalent in this mostly African-American HIV-HCV-coinfected population, but was not related to BMD or liver disease severity. These data suggest that efforts to increase vitamin D levels in this population may not improve bone or liver outcomes.

AB - Background: Fractures and cirrhosis are major causes of morbidity and mortality among HIV-HCV-coinfected individuals. It is not known whether vitamin D deiciency is associated with these outcomes. Methods: Between 2005 and 2007, 116 HIV-HCVcoinfected individuals underwent dual-energy X-ray absorptiometry within 1 year of a liver biopsy. 25-Hydroxyvitamin D (25OHD) and parathyroid hormone were measured from archived samples. Low bone mineral density (BMD) was deined as BMD=2 standard deviations lower than age-, sex- and race-matched controls (Z-score =-2.0) at the total hip, femoral neck or lumbar spine. Histological ibrosis staging was assessed according to the METAVIR system (0 [no ibrosis] to 4 [cirrhosis]). Results: The cohort was 87% African-American and 63% male. The median age (IQR) was 49.9 years (46.5-53.3). A total of 89% had a CD4+ T-cell count <200 cells/mm3 and 64% were receiving HAART. The median 25OHD was 19 ng/ ml (IQR 11.0-26.0). Hypovitaminosis D (25OHD=15 ng/ml) was present in 41% and secondary hyperparathyroidism, deined by parathyroid hormone <65 pg/ml, was present in 24%. In total, 27% had low BMD (Z-score -2) at the spine, femoral neck or total hip, and 39% had signiicant hepatic ibrosis (METAVIR=2). In multivariate analysis, vitamin D deiciency was not associated with signiicant ibrosis or with BMD at any site. Conclusions: Vitamin D deiciency was highly prevalent in this mostly African-American HIV-HCV-coinfected population, but was not related to BMD or liver disease severity. These data suggest that efforts to increase vitamin D levels in this population may not improve bone or liver outcomes.

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