Metabolic Disorders of Vitamin D and Parathyroid Hormone in Patients Living with Human Immunodeficiency Virus Type 1 Taking Antiretroviral Treatment in Côte d’Ivoire

Background: A number of studies have highlighted the phosphocalcic balance disorder and posed the problem of the correlation between 25-hydroxyvitamin D3 and parathyroid hormone in people living with HIV (PLHIV). However, few studies have been conducted on the link between antiretroviral therapy and the level of 25 (OH) D3 during HIV infection. The objective of this study was to evaluate 25 (OH) D3 and the parathyroid status in HIV-infected people taking antiretroviral treatment in Côte d'Ivoire.

Methods: The study involved 326 adults (163 HIV-infected patient and 163 control subjects). CD4 count was performed in flow cytometry. 25 (OH) D3 was assayed by HPLC. Parathyroid hormone was assayed using COBAS 6000.

Results: The deficiency of 25 (OH) D3 was observed in patients aged 18 to 25 years and in patients on AZT-3TC-EFV (13 ± 0.68 ng / mL), AZT-3TC-NVP (11 ± 0.15 ng / mL) and TDF-3TC-EFV (19 ± 0.57 ng / mL). Sufficient levels of 25 (OH) D3 were observed in patients receiving TDF-3TC-LPV/r. 25 (OH) D3 deficiency was observed in women receiving AZT-3TC-EFV, AZT-3TC-LPV/r or TDF-3TC-EFV and men receiving AZT-3TC-NVP or AZT-3TC-LPV/r. The levels of PTH were normal in all patients aged 26 to 34 years and treated with AZT-3TC-EFV (9 ± 0.08 pg / mL), AZT-3TC-NVP (7 ± 0.21 pg / mL) or TDF-3TC-EFV (8 ± 0.25 pg / mL). Patients with CD4+ count between 349 and 200 cells / mm3 and patients who were treated with AZT-3TC-NVP (7 ± 0.21 pg/ mL) also had normal PTH levels.

Conclusion: Some antiretroviral combinations prescribed in Côte d'Ivoire induce a decrease in the serum level of vitamin D and parathyroid hormone in PLHIV. It would, therefore, be necessary to add a vitamin D supplement when prescribing these combinations, considering its importance in cellular metabolism.