Monthly or Weekly Supplementation with Cholecalciferol 20,000 IU in People Living with HIV: Results from a Nested Cohort Study

Overview

Journal Interdiscip Perspect Infect Dis

Publisher Wiley

Date 2018 Sep 25

PMID 30245713

Citations 1

Authors

Sebastian Noe

Christine I Moeckel

Christiane Schwerdtfeger

Celia Oldenbuettel

Hans Jaeger

Eva Wolf

Christoph D Spinner

Affiliations

Soon will be listed here.

Abstract

Background: There is still considerable uncertainty in handling vitamin D deficiency in people living with HIV (PLWH), due to a lack of comparative data and the wide range of recommended daily intake. Nondaily supplementation might be preferred in many PLWH, but recommendation on dosing has not been established. We aimed to compare the efficacy of weekly versus monthly supplementation with cholecalciferol 20,000 IU in a group of PLWH with vitamin D deficiency in Western Europe.

Study Design: Longitudinal, retrospective nested cohort study of PLWH from two large clinical care centers in Munich, Germany.

Results: Of 307 patients with vitamin D deficiency, 124 patients received vitamin D supplementation (weekly supplementation in 84 (67.7%)). 46.4% and 22.5% of patients achieved 25(OH)D levels ≥30 ng/mL after 12 months of weekly and monthly supplementation with cholecalciferol 20,000 IU, respectively (p=0.011). Dosing interval as well as 25(OH)D baseline levels >15 ng/mL were associated with the normalization of 25(OH)D.

Conclusion: A higher rate of 25(OH)D level normalization can be achieved via weekly supplementation. For several PLWH, even a weekly dose of cholecalciferol 20,000 IU might not be adequate to maintain 25(OH)D levels >30 ng/mL without an initial "loading" dose. The response to supplementation is poorly predictable at an individual level.

Citing Articles

The Regulation of Marrow Fat by Vitamin D: Molecular Mechanisms and Clinical Implications.

Sadie-Van Gijsen H Curr Osteoporos Rep. 2019; 17(6):405-415.

PMID: 31749086 DOI: 10.1007/s11914-019-00546-6.

References

Falasca K, Ucciferri C, Di Nicola M, Vignale F, Di Biase J, Vecchiet J . Different strategies of 25OH vitamin D supplementation in HIV-positive subjects. Int J STD AIDS. 2014; 25(11):785-92. DOI: 10.1177/0956462414520804. View

Coelho L, Cardoso S, Luz P, Hoffman R, Mendonca L, Veloso V . Vitamin D3 supplementation in HIV infection: effectiveness and associations with antiretroviral therapy. Nutr J. 2015; 14:81. PMC: 4538921. DOI: 10.1186/s12937-015-0072-6. View

Bursac Z, Gauss C, Williams D, Hosmer D . Purposeful selection of variables in logistic regression. Source Code Biol Med. 2008; 3:17. PMC: 2633005. DOI: 10.1186/1751-0473-3-17. View

Eckard A, ORiordan M, Rosebush J, Lee S, Habib J, Ruff J . Vitamin D supplementation decreases immune activation and exhaustion in HIV-1-infected youth. Antivir Ther. 2017; 23(4):315-324. PMC: 6070412. DOI: 10.3851/IMP3199. View

Giacomet V, Vigano A, Manfredini V, Cerini C, Bedogni G, Mora S . Cholecalciferol supplementation in HIV-infected youth with vitamin D insufficiency: effects on vitamin D status and T-cell phenotype: a randomized controlled trial. HIV Clin Trials. 2013; 14(2):51-60. DOI: 10.1310/hct1402-51. View

Panayiotopoulos A, Bhat N, Bhangoo A . Bone and vitamin D metabolism in HIV. Rev Endocr Metab Disord. 2013; 14(2):119-25. DOI: 10.1007/s11154-013-9246-8. View

Allavena C, Delpierre C, Cuzin L, Rey D, Viget N, Bernard J . High frequency of vitamin D deficiency in HIV-infected patients: effects of HIV-related factors and antiretroviral drugs. J Antimicrob Chemother. 2012; 67(9):2222-30. DOI: 10.1093/jac/dks176. View

Dave J, Cohen K, Micklesfield L, Maartens G, Levitt N . Antiretroviral Therapy, Especially Efavirenz, Is Associated with Low Bone Mineral Density in HIV-Infected South Africans. PLoS One. 2015; 10(12):e0144286. PMC: 4669137. DOI: 10.1371/journal.pone.0144286. View

Noe S, Oldenbuettel C, Heldwein S, Jaeger H, Wolf E . Patterns of vitamin D, parathyroid hormone and c-terminal telopeptide of collagen type 1 in Caucasian and African descent HIV-infected populations in Central Europe. Infect Dis Rep. 2017; 9(3):7265. PMC: 5641664. DOI: 10.4081/idr.2017.7265. View

10.

Yin M, Brown T . HIV and Bone Complications: Understudied Populations and New Management Strategies. Curr HIV/AIDS Rep. 2016; 13(6):349-358. DOI: 10.1007/s11904-016-0341-9. View

11.

Lake J, Hoffman R, Tseng C, Wilhalme H, Adams J, Currier J . Success of Standard Dose Vitamin D Supplementation in Treated Human Immunodeficiency Virus Infection. Open Forum Infect Dis. 2015; 2(2):ofv068. PMC: 4462892. DOI: 10.1093/ofid/ofv068. View

12.

Foissac F, Treluyer J, Souberbielle J, Rostane H, Urien S, Viard J . Vitamin D3 supplementation scheme in HIV-infected patients based upon pharmacokinetic modelling of 25-hydroxycholecalciferol. Br J Clin Pharmacol. 2012; 75(5):1312-20. PMC: 3635601. DOI: 10.1111/bcp.12006. View

13.

von Elm E, Altman D, Egger M, Pocock S, Gotzsche P, Vandenbroucke J . The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg. 2014; 12(12):1495-9. DOI: 10.1016/j.ijsu.2014.07.013. View

14.

Noe S, Heldwein S, Pascucchi R, Oldenbuttel C, Wiese C, Von Krosigk A . Cholecalciferol 20 000 IU Once Weekly in HIV-Positive Patients with Low Vitamin D Levels: Result from a Cohort Study. J Int Assoc Provid AIDS Care. 2017; 16(4):315-320. DOI: 10.1177/2325957417702487. View

15.

Chun R, Liu N, Lee T, Schall J, Denburg M, Rutstein R . Vitamin D supplementation and antibacterial immune responses in adolescents and young adults with HIV/AIDS. J Steroid Biochem Mol Biol. 2014; 148:290-7. PMC: 4312738. DOI: 10.1016/j.jsbmb.2014.07.013. View

16.

Holick M, Binkley N, Bischoff-Ferrari H, Gordon C, Hanley D, Heaney R . Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011; 96(7):1911-30. DOI: 10.1210/jc.2011-0385. View

17.

Cervero M, Agud J, Garcia-Lacalle C, Alcazar V, Torres R, Jusdado J . Prevalence of vitamin D deficiency and its related risk factor in a Spanish cohort of adult HIV-infected patients: effects of antiretroviral therapy. AIDS Res Hum Retroviruses. 2012; 28(9):963-71. DOI: 10.1089/AID.2011.0244. View

18.

Grant W, Karras S, Bischoff-Ferrari H, Annweiler C, Boucher B, Juzeniene A . Do studies reporting 'U'-shaped serum 25-hydroxyvitamin D-health outcome relationships reflect adverse effects?. Dermatoendocrinol. 2016; 8(1):e1187349. PMC: 4951179. DOI: 10.1080/19381980.2016.1187349. View

19.

Cook P, Stang A, Walker L, Akula S, Cook F . Bone Mineral Density and Vitamin D Levels in HIV Treatment-Naïve African American Individuals Randomized to Receive HIV Drug Regimens. South Med J. 2016; 109(11):712-717. DOI: 10.14423/SMJ.0000000000000560. View

20.

Rovner A, Stallings V, Rutstein R, Schall J, Leonard M, Zemel B . Effect of high-dose cholecalciferol (vitamin D) on bone and body composition in children and young adults with HIV infection: a randomized, double-blind, placebo-controlled trial. Osteoporos Int. 2016; 28(1):201-209. DOI: 10.1007/s00198-016-3826-x. View