A study in The Journal of Clinical Endocrinology and Metabolism investigated the efficacy of monthly vitamin D supplementation to treat vitamin D insufficiency and deficiency in HIV positive young adults.
This randomized controlled trial (RCT) was conducted in HIV positive adults between the ages of 18 and 24 that were on stable antiretroviral therapy. Participants received either 50,000 IUs of D3 once a month for three months or a placebo.
All participants had a viral load below 5,000 copies. Viral load is a measure of the number of viruses in circulation. The higher the number, the more the virus is reproducing and the quicker the disease is likely to progress. Patients receiving the common antiviral therapy, efavirenz, have lower serum 25(OH)D levels than patients on different antiviral medications.
Compliance with the HIV medication regimen is a significant issue for young, HIV-infected patients, and the more pills in a regimen, the less likely the patient is to take them. For this reason the study authors chose to dose the treatment group with vitamin D once per month.
In the group receiving vitamin D treatment, average serum levels rose from 21.9 to 35.9 ng/mL. At the end of the 12 week period, 76 participants in the treatment group had levels above 20 ng/mL – the cutoff the authors chose to use — while 3 participants had levels below 20 ng/mL. Eight had levels above 50 ng/mL.
Participants with the lowest baseline 25(OH)D serum levels saw the greatest gains in vitamin D levels with treatment, but this relationship disappeared after adjustment for multiple confounders. While participants taking efavirnez had the lowest serum 25(OH)D levels initially, there was no evidence that the medication hampered their ability to respond to treatment. The authors note that D3 is more effective than D2 at not only raising levels but maintaining them, and may therefore be the preferred choice for once monthly dosing regimens.
Once monthly dosing of young patients with HIV is an effective way to raise vitamin D levels above 20 ng/mL, but this study did not look for any relationships between different serum 25(OH)D levels and health outcomes. It is important that more RCT’s be conducted in HIV positive patients to determine if vitamin D supplementation can affect biochemical markers of the disease.