{"id":6127,"date":"2009-12-31T12:49:52","date_gmt":"2009-12-31T11:49:52","guid":{"rendered":"http:\/\/moomango.co.uk\/htb\/?p=6127"},"modified":"2013-08-05T05:50:37","modified_gmt":"2013-08-05T05:50:37","slug":"reduced-levels-of-vitamin-d-in-patients-taking-efavirenz","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/6127","title":{"rendered":"Reduced levels of vitamin D in patients taking efavirenz"},"content":{"rendered":"

Simon Collins, HIV i-Base<\/strong><\/p>\n

Todd Brown and colleagues from Johns Hopkins University presented results from a retrospective analysis that supports a link between efavirenz and reduced levels of vitamin D.<\/strong> [1]<\/p>\n

The study compared 25-(OH) vitamin D levels from stored samples from 87 treatment naive patients and compared this to levels 6-12 months after starting treatment containing efavirenz (n=51) or non-efavarinz (n=36; 89% PI-based).<\/p>\n

Several studies have reported an association between NNRTIs and reduced levels of vitamin D, including a recent UK study linking low levels to the use of efavirenz. [2]<\/p>\n

The current study reported a prevalence of mild, moderate and severe vitamin D deficiency at baseline in 84% (<32 ng\/mL\/<80 nmol\/L), 56%% (<20 ng\/mL\/<50 nmol\/L) and 33% (<15 ng\/mL\/< 37.5 nmol\/L) patients respectively. Median levels were lower in non-white compared to white patients (16 vs 30 ng\/mL, p<0.0001) and in winter compared to summer (15 vs 27 ng\/mL, p<0.001).<\/p>\n

Factors associated with low levels at baseline included race (Prevalence Ratio 6.7 95%CI: 1,7, 25.6; p=0.006), season (PR 4.6; 1.2, 17.8; p=0.03) and duration of HIV infection (PR 1.06; 1.02, 11.09; p=0.003).<\/p>\n

Pre- and post-HAART levels in the efavirenz group dropped from 22.6 to 18.4 and increased from 21.2 to 22.9 in the non-efavirenz group (p=0.05 between group comparison post-HAART). After adjusting for baseline 25(OH)D, race and season, the adjusted mean difference between group was -5.1 +1.5 ng\/mL, (p=0.001). Using the <15 nmol\/mL cut-off the percentage of patients with severe depletion increased from 27% to 48% in the efavirenz group and reduced from 42% to 31% in the non-efavirenz group.<\/p>\n

The adjusted prevalence ratio for efavirenz use was 1.8 (95%CI 1,2, 2,8, p=0.007).<\/p>\n

No association was found with use of tenofovir, abacavir or AZT.<\/p>\n

References:<\/p>\n

    \n
  1. Brown TT et al. Association between initiation of antiretroviral therapy with efavirenz and decreases in 25-hydroxyvitamin D. 11th Intl Workshop on Adverse Drug Reactions. 26-28 October 2009, Philadelphia. Oral abstract O-20. Antiviral therapy 2009; 14 Suppl 2: A15.<\/li>\n
  2. Welz et al. Efavirenz use is associated with severe Vitamin D deficiency in a large, ethnically diverse urban UK HIV cohort. Poster abstract TUPEB186. 5th IAS conference, 19-22 July 2009, Cape Town.
    \nhttp:\/\/www.ias2009.org\/pag\/Abstracts.aspx?AID=3402<\/a><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Simon Collins, HIV i-Base Todd Brown and colleagues from Johns Hopkins University presented results from a retrospective analysis that supports a link between efavirenz and reduced levels of vitamin D. [1] The study compared 25-(OH) vitamin D levels from stored …<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[125],"class_list":["post-6127","post","type-post","status-publish","format-standard","hentry","category-conference-reports","tag-lipo-11th-2009"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/6127","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=6127"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/6127\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=6127"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=6127"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=6127"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}