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Published Online: 12 August 2010

Short Communication: Inadequate Vitamin D Exacerbates Parathyroid Hormone Elevations in Tenofovir Users

Publication: AIDS Research and Human Retroviruses
Volume 26, Issue Number 8

Abstract

Parathyroid hormone (PTH) elevations are associated with reduced bone mineral density and adverse health outcomes and have been reported in patients with HIV infection. We aimed to examine the impact of vitamin D status and tenofovir (TDF) use on PTH levels among HIV-infected patients receiving combination antiretroviral therapy (cART). Demographics, medication and supplement use, and clinical data, including 25-hydroxyvitamin D [25(OH)D] and PTH, were collected on 45 HIV-infected men on ART. Suboptimal vitamin D status was defined as 25(OH)D < 30 ng/ml. The relationship between antiretroviral agents, suboptimal 25(OH)D, and PTH levels was examined. Among subjects with suboptimal vitamin D status, PTH values greater than or equal to the ULN (87 pg/ml) were more common among TDF users than nonusers: 41% versus 0% (p = 0.018); and median PTH was higher in TDF users: 80 pg/ml versus 55 pg/ml (p = 0.02). Among TDF users, PTH was higher in the group with suboptimal 25(OH)D (p = 0.045). Multivariable linear regression showed that PTH was independently and directly related to TDF use (p = 0.017) and inversely related to 25(OH)D (p = 0.017). PTH was not related to the estimated glomerular filtration rate (p = 0.9). In this cross-sectional study of HIV-infected men on ART, the use of TDF and the level of 25(OH)D were independently associated with PTH levels. Because TDF is a potent and widely used antiretroviral drug, information about cofactors that may exacerbate its side effects is of significant clinical value.

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cover image AIDS Research and Human Retroviruses
AIDS Research and Human Retroviruses
Volume 26Issue Number 8August 2010
Pages: 855 - 859
PubMed: 20672993

History

Published online: 12 August 2010
Published in print: August 2010
Published ahead of print: 30 July 2010

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Kathryn E. Childs
Division of Infectious Diseases, Mount Sinai School of Medicine, New York, New York.
Sarah L. Fishman
Division of Liver Disease, Mount Sinai School of Medicine, New York, New York.
Catherine Constable
Division of Liver Disease, Mount Sinai School of Medicine, New York, New York.
Julio A. Gutierrez
Division of Liver Disease, Mount Sinai School of Medicine, New York, New York.
Christina M. Wyatt
Division of Nephrology, Department of Medicine, Mount Sinai School of Medicine, New York, New York.
Douglas T. Dieterich
Division of Liver Disease, Mount Sinai School of Medicine, New York, New York.
Michael P. Mullen
Division of Infectious Diseases, Mount Sinai School of Medicine, New York, New York.
Andrea D. Branch
Division of Liver Disease, Mount Sinai School of Medicine, New York, New York.

Notes

Address correspondence to:Andrea D. BranchDivision of Liver DiseaseDepartment of MedicineMount Sinai School of Medicine1425 Madison Avenue, Room 11-24New York, New York 10029E-mail: [email protected]

Author Disclosure Statement

No competing financial interests exist.

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