High Rates of Vitamin D deficiency among HIV-infected and At-risk Women in the United States Oluwatoyin M Adeyemi, Denis Agniel, Audrey L French, Phyllis.

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High Rates of Vitamin D deficiency among HIV-infected and At-risk Women in the United States Oluwatoyin M Adeyemi, Denis Agniel, Audrey L French, Phyllis Tien, Kathleen Weber, Marshall J Glesby, Maria C Villacres, Anjali Sharma, Daniel Merenstein, Elizabeth T Golub, William Meyer and Mardge Cohen for the WIHS group. WEPDB101

Background and Methods Vitamin D plays an important role in overall health. Study to determine the prevalence and predictors of vitamin D deficiency among HIV-infected and uninfected women enrolled in the Women’s Interagency HIV study (WIHS). Cross-sectional study of 1760 WIHS participants (1254 HIV- infected and 506 HIV-uninfected) who had stored sera collected from visit 27 (October 1, 2007-March 30, 2008). Vitamin D testing was performed by Quest Diagnostics on frozen sera stored at -70°C using the liquid chromatography/mass spectroscopy(LC-MS) method. Vitamin D deficiency was defined as 25 (OH) D <20 ng/ml; severe deficiency <10ng/ml. (To convert to nmol/L multiply by 2.496)

Results  Median age 44 yrs, 61% African American, 22% White, 14% Hispanic.  For HIV+ women, median CD4 495 (295,662)  66% of all women had Vitamin D Deficiency ; 22% severe deficiency (<10ng/ml)  62% of HIV+ vs 75% of HIV- women were vitamin D deficient (p<0.001).  Median vitamin D levels were higher in HIV-infected (16, IQR 10-25) than HIV-uninfected women (14, IQR 9-20).  Only 13% had sufficient Vitamin D levels (>30ng/ml).

Multivariate Model Variable OR (95% CI) P value HIV ( ) 0.02 Age, yrs0.79 ( ) 1 <0.001 African American Hispanic 3.27 ( ) 1.43 ( ) < BMI1.41 ( ) 1 <.001 Los Angeles Chicago 0.61 ( ) 0.62 ( ) HIV+ Only Undetectable HIVRNA 0.67 ( ) 0.01 CD4 count < ( ) ( ) Current PI use0.66 ( )0.01 Current Efavirenz use1.64 ( )0.05 [ 1] For 10-unit increase 2 Estimated with restricted cubic spline function of CD4 Count, using midpoint of range Factors associated with Vitamin D Deficiency among 1760 WIHS women

Conclusions  High prevalence of Vitamin D deficiency in the WIHS- (largest study to date on vitamin D in HIV infected adults).  African American women had the highest rates of Vitamin D deficiency.  HIV infection was associated with lower rates of vitamin D deficiency.  In HIV+ women, Efavirenz use was associated with lower Vitamin D levels.  Important to explore response to vitamin D supplementation and impact on a myriad of health outcomes.