High-dose vitamin D supplementation given for 12 months decreases bone turnover markers in HIV-infected youth with vitamin D insufficiency, according to a study published in the Journal of Acquired Immune Deficiency Syndromes.
Allison Ross Eckard, MD, from the Medical University of South Carolina in Charleston, and colleagues conducted a randomized, active-control, double-blind 2-year trial and recruited HIV-infected patients from the Cleveland Medical Center and the Grady Health System in Atlanta. Youth were eligible if they were between 8 and 25 years old with baseline serum 25-hydroxyvitamin D (25(OH)D) concentrations less than 30 ng/mL.
The authors investigated bone parameters using 3 different vitamin D3 doses (18,000 [standard/control dose], 60,000 [moderate dose], and 120,000 IU/monthly [high dose]). Patients took 2 capsules of either 9,000 IU, 30,000 IU, or 60,000 IU at baseline and then monthly and returned for study visits every 3 months. Bone mineral density and bone turnover markers were measured at baseline and 12 months.
A total of 102 HIV-infected patients were enrolled; 81 subjects completed their 12-month visit. A total of 30, 24, and 27 patients were in the standard, moderate, and high-dose groups, respectively. Over 12 months, serum 25(OH)D concentrations increased with all doses, but the high dose maintained serum 25(OH)D concentrations in an optimal range (≥30 ng/mL or ≥20 ng/mL) throughout the study period for more patients (85% and 93%, respectively) compared with either the moderate (54% and 88%, respectively) or standard dose (63% and 80%, respectively).
All dosing groups showed some improvement in bone mineral density; however, only the high-dose arm showed significant decreases in bone turnover markers for both procollagen type 1 amino-terminal propeptide (-3.7 ng/mL) and Β-CrossLaps (-0.13 ng/mL).
“We showed that high-dose vitamin D supplementation (120,000 IU/month) decreases bone turnover markers, which may reflect an early, beneficial effect on bone health in HIV that could result in clinically meaningful changes over time,” stated the authors. “Likewise, a higher dose of vitamin D supplementation is needed to achieve optimal 25(OH)D concentrations for this population.”
- Eckard AR, O’Riordan MA, Rosebush JC, et al. Effects of vitamin D supplementation on bone mineral density and bone markers in HIV-infected youth. J Acquir Immune Defic Syndr. 2017 Sep 11. doi: 10.1097/QAI.0000000000001545