VITAMIN D AND HIV INFECTION: THE CORRELATION & NEED FOR EVALUATION

Abstract

Background: India is the country with the third highest HIV disease burden globally. One of the most common long-term complications of HIV infection is bone diseases. There is prevalence of reduced bone mineral density (BMD) and thus higher risk of fragility fractures among PLHIV. Further, many HIV-positive cohorts suggest Vitamin-D hypovitaminosis exposing to osteopenia/osteoporosis in this population. This detailed review would provide an insight on correlation of Vitamin-D hypovitaminosis and HIV infection. Material & Methods: A thorough review of published research studies and literature work was conducted. These studies were selected on the basis of data available on HIV seropositive population and Vitamin D in peer reviewed indexed journals.  Both prospective and retrospective studies with or without control groups and randomized-controlled trials (RCTs) reporting baseline vitamin D status in HIV seropositive patients were included. Results: We reviewed the association of vitamin D deficiency with HIV progression, mortality, and AIDS events, increased incidence and severity of Mycobacterium tuberculosis (TB) and hepatitis C virus (HCV) infection. Low bone mineral density (BMD) is a challenging metabolic condition in PLHIV. Further, the impact of antiretroviral drugs on vitamin D metabolism was studied. The effect of body index mass and non- and nucleoside reverse transcriptase inhibitors effects with hypovitaminosis D was further reviewed along with supplementation therapy of the vitamin and its effect in HIV positive population. Conclusion: The optimal levels of 1,25(OH)Vitamin D is necessary for regulation of calcium and phosphorus balance for bone mineralization and remodelling. Without its adequate level in bloodstream; dietary calcium cannot be absorbed and thus causes a low BMD.