Prevalence and risk factors of vitamin D deficiency among living with HIV adults receiving antiretroviral treatment in tropical area: Cross-sectional study

BACKGROUND: There was found HIV infection have a higher rate of vitamin D deficiency (VDD) than the general population, even a slight deficiency, can increase the risk of osteoporosis in adults. This study aimed to determine the prevalence and risk factors of VDD in HIV-infected adults receiving antiretroviral therapy (ART) in a tropical area. METHODS: A cross-sectional study of an HIV-clinical population-based cohort was conducted at Police General Hospital (PGH), from 1(st) August 2020 to 31(st) July 2021, in Bangkok, Thailand. Serum 25(OH)D level was measured using ECLIA. All other laboratory investigations were conducted at the PGH's central lab center. The descriptive analysis utilized frequency (percentages) and mean (SD) as appropriate variable types. Chi-square tests (χ2) and independent samples t-tests were used to differentiate between VDD and non-VDD groups. To determine the association between VDD and non-VDD, gender, age (years), BMI discrepancy, ART regimens, ART-duration (years), HIV viral load, and CD4 count (cells/mm(3)). Univariate and multivariable logistics regression was conducted, respectively. RESULTS: Of 602 patients, 66.4% were females with mean age of 45.22 ± 10.23 years. The average serum 25(OH)D level was 18.69 ± 7.23 ng/ml. The prevalence of VDD (<20 ng/ml) and insufficiency (VDI) (20–29.9 ng/ml) was 58.5% and 35.2%, respectively. Risk factors associated with vitamin D inadequacy were increasing age (AOR = 1.05, 95%CI = 1.03–1.07, P < .001), efavirenz (EFV-based) use (AOR = 6.07, 95%CI = 3.57–10.31, P < .001), while male (AOR = 0.44, 95%CI = 0.29–0.66, P < .001), body mass index (BMI) lower than 18.5 (AOR = 0.26; 95% CI, 0.11–0.62, P = .002), protease Inhibitors (PIs-based) use (AOR = 0.18, 95%CI = 0.11–0.30, P < .001),and CD4 count <200 cells/mm(3) (AOR = 0.41; 95% CI, 0.20–0.85, P = .017) were associated with less VDD. CONCLUSION: The implementation of focused strategies for vitamin D supplementation, specifically targeting older patients and patients undergoing EFV-based ART regimen, can serve as a valuable addition to comprehensive HIV management. By optimizing vitamin D levels, there is a potential to improve health outcomes and enhance overall well-being for individuals living with HIV.