Higher Vitamin D Dosage Doesn't Help Bone Metabolism in HIV-Positive Children

FEBRUARY 16, 2017
Caitlyn Fitzpatrick
pediatrics, infectious disease, HIV/AIDS, human immunodeficiency virus, acquired immunodeficiency syndrome, pharmacy, supplements, calcium, vitamin D, bone health, osteoporosis, 25OHD

“Adverse bone health is a non-communicable condition during the course life-long HIV treatment,” researchers said in their presentation at the Conference on Retroviruses and Opportunistic Infections (CROI 2017) in Seattle, Washington.

Around 4% to 8% of kids and adolescents with HIV in high-income countries have a bone mineral density (BMD) z-score of <-2, which is considered low. That proportion jumps to 16% to 32% in middle-income countries. Thailand-based researchers set out to find if dual supplementation with vitamin D and calcium could help.

The 48-week study began enrolling adolescents ages 10 to 20 with HIV in April 2015. The Thai children had a history of virologic suppression, which was characterized as HIV RNA <400 copies/mL.

None of the patients had bone fracture history, received treatment for low BMD, received supplementation for calcium or vitamin D (more than 1,000 mg and 400 IU daily, respectively), or received any medications that impact bone metabolism.

Based on the World Health Organization’s (WHO) classification, the 166 adolescents fell in the following HIV stages before starting antiretroviral therapy (ART): 74 patients (47.1%) in stages 1 and 2, 31 patients (19.8%) in stage 3, 48 patients (30.6%) in stage 4, and four patients (2.5%) were unknown.

BMD was measured at baseline and 48 weeks using the dual-energy X-ray absorptiometry (DXA) technique. They were randomly assigned to one of two groups:
  • Normal-dose: 83 patients received 600 mg of elemental calcium and 200 IU of vitamin D3 (one tablet twice daily)
  • High-dose: 83 patients received 600 mg of elemental calcium and 200 IU of vitamin D3 (one tablet twice daily), as well as 20,000 IU vitamin D2 (one capsule once weekly)

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