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T Rashid, E Devitt , S Mandalia, I Meryon, L Waters, M Bower, R Jones, M Nelson

No Association of Vitamin D Levels with Individual Antiretroviral Agents, Duration of HIV Infection, Alkaline Phosphatase Levels nor Bone Mineral Density Findings. T Rashid, E Devitt , S Mandalia, I Meryon, L Waters, M Bower, R Jones, M Nelson Department of HIV Medicine

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T Rashid, E Devitt , S Mandalia, I Meryon, L Waters, M Bower, R Jones, M Nelson

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  1. No Association of Vitamin D Levels with Individual Antiretroviral Agents, Duration of HIV Infection, Alkaline Phosphatase Levels nor Bone Mineral Density Findings T Rashid, E Devitt, S Mandalia, I Meryon, L Waters, M Bower, R Jones, M Nelson Department of HIV Medicine Chelsea and Westminster Hospital London, UK

  2. Introduction • It is estimated that one billion people worldwide are vitamin D deficient • Vitamin D deficiency can lead to inadequate bone mineral density (BMD), muscle weakness, cardiovascular disease & insulin resistance • Vitamin D has also been shown to have an immunomodulatory role • Analyses have shown a high prevalence of vitamin D deficiency in large cohorts of HIV positive individuals • Does anti retroviral therapy play a role in vitamin D deficiency in HIV infected individuals?

  3. Methods • Consecutive patients visiting the dedicated HIV clinic in July 2009 had blood samples collected for analysis of total 25(OH) vitamin D levels • Data were collected retrospectively detailing gender, ethnicity, age, current treatment regimen, HIV viral load, CD4 count, duration of HIV infection and bone mineral density scan results • The level of vitamin D was defined as: • Normal >70 nmol/L • Insufficient 40-70 nmol/L • Deficient <40 nmol/L.

  4. Results • N = 312 • Age 48 years (range 25-83) • 88% male • 78% Caucasian • CD4 454 (78-1675) • All on cART • 91% VL<50cpm • Duration of HIV infection 12 years (range 0-26 years)

  5. Results Median vitamin D level 66nmol/L (range <10-221) 35% (109) = insufficient 21% (64) = deficient DEXA in 33% (102)

  6. Results * Mean vitamin D levels (nmol/L) were derived using Linear Least Squares Regression Model

  7. Conclusion • Vitamin D levels below the normal range were correlated with non-caucasian ethnicity (p<0.001) and female sex (p<0.001) • No association with any antiretroviral class or specific agent, including efavirenz • No association of Vitamin D with alkaline phosphatase levels

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