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An oral high dose of cholecalciferol restores vitamin D status in deficient postmenopausal HIV-1-infected women independently of protease inhibitors therapy: a pilot study

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Abstract

The best repletion and maintenance dosing regimens with cholecalciferol in vitamin D-deficient HIV-1 patients remain unknown. Protease inhibitors (PIs) have been shown to inhibit vitamin D 1α- and 25α-hydroxylation in hepatocyte and monocyte cultures. We therefore evaluated the effect of a single high dose of cholecalciferol in vitamin D-deficient HIV-1 postmenopausal women undergoing treatment with highly active anti-retroviral therapy (cART), with and without PIs. Forty HIV-1 postmenopausal women treated with cART, with hypovitaminosis D (<20 ng/ml), were enrolled. We measured serum changes of 25-hydroxyvitamin D [25(OH)D]; 1,25-dihydroxyvitamin D [1,25(OH)2D], parathyroid hormone (PTH), serum calcium, and urinary calcium excretion following a loading dose of 600,000 IU of cholecalciferol after 3, 30, 60, 90, and 120 days. Patients were divided into two groups, whether or not they were taking PI. A significant increase in mean 25(OH)D and 1,25(OH)2D levels at day 3 and throughout the entire observation period was found in both groups (p < 0.001). PTH levels concomitantly decreased in both groups (p < 0.001). Mean albumin-adjusted serum calcium increases with respect to baseline were significant only at day 3 and day 30 for both groups (p < 0.01). Considering remaining parameters, there were no significant differences between the groups at any time, by two-way RM ANOVA. An oral dose of 600,000 IU of cholecalciferol in HIV-1 postmenopausal women rapidly increases 25(OH)D and 1,25(OH)2D levels reducing PTH levels, regardless of the presence of PIs in the cART scheme.

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Acknowledgments

S.M. served as speaker for Abiogen, Amgen, Bruno Farmaceutici, Eli Lilly, Italfarmaco, Merck Sharp & Dohme, Takeda. He also served in advisory board of Amgen, Eli Lilly, Merck Sharp & Dohme. I.M. served as speaker for Merck Sharp & Dohme, Bristol-Myers Squibb, ViiV Healthcare, Jansenn-Cilag; served on an advisory board for Abbvie and Jansenn-Cilag The other authors have nothing to disclose. This research did not receive any specific grant from any funding agency in the public, commercial, or not profit sector.

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Authors and Affiliations

  1. Department of Internal Medicine and Medical Disciplines, “Sapienza” University, Viale del Policlinico 155, 00161, Rome, Italy

    Jessica Pepe, Piergianni Biondi, Cristiana Cipriani, Mirella Cilli & Salvatore Minisola

  2. Department of Clinical Medicine, “Sapienza” University, Viale del Policlinico 155, 00161, Rome, Italy

    Ivano Mezzaroma & Alessandra Fantauzzi

  3. Department of Public Health and Infectious Diseases, “Sapienza” University, Viale del Policlinico 155, 00161, Rome, Italy

    Mario Falciano, Alessandra Salotti & Mario Di Traglia

  4. Department of Radiology, “Sapienza” University, Viale del Policlinico 155, 00161, Rome, Italy

    Daniele Diacinti

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  1. Jessica Pepe
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Correspondence to Jessica Pepe.

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Pepe, J., Mezzaroma, I., Fantauzzi, A. et al. An oral high dose of cholecalciferol restores vitamin D status in deficient postmenopausal HIV-1-infected women independently of protease inhibitors therapy: a pilot study. Endocrine 53, 299–304 (2016). https://doi.org/10.1007/s12020-015-0693-8

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  • DOI: https://doi.org/10.1007/s12020-015-0693-8

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