Vitamin D may improve bone health in those taking anti-HIV drug

By Robert Bock and John McGrath

Vitamin D may help prevent hormonal changes that can lead to bone loss among those being treated for HIV with the drug tenofovir, according to the results of a National Institutes of Health network study of adolescents with HIV.

Tenofovir is widely used to treat . However, the drug causes symptoms that resemble those of ods.od.nih.gov/factsheets/VitaminD-QuickFacts, causing bones to lose calcium and reducing bone density. The study found that large monthly doses of vitamin D reduced blood levels of a hormone that stimulates from bones.

"What we've found suggests vitamin D could be used to counteract one of the major concerns about using tenofovir to treat HIV," said Rohan Hazra, M.D., of the Pediatric, Adolescent and Maternal AIDS Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the NIH institute that funds the networks. "People in their teens and twenties may be on anti-HIV treatment for decades to come, so finding a safe and inexpensive way to protect their long-term would be a major advance."

The findings were published online in .

Vitamin D helps the body absorb calcium to build bones. When the body is deficient in vitamin D, levels of a hormone called parathyroid hormone rise. This rise triggers activity that draws calcium from bones. As a result, the bones become more fragile and can break more easily. Parathyroid hormone also tends to be elevated in people taking tenofovir, whether or not they have sufficient vitamin D.

Because parathyroid hormone levels are elevated in people taking tenofovir in much the same way as they are in people with vitamin D deficiency, the researchers theorized that vitamin D might counteract the bone-depleting effects of tenofovir.

The study was conducted by first author Peter L. Havens, M.D., of the Medical College of Wisconsin and Children’s Hospital of Wisconsin, Milwaukee; Dr. Hazra; Kathleen Mulligan, Ph.D., of the University of California at San Francisco; and other researchers affiliated with the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) and the International Maternal–Pediatric–Adolescent AIDS Clinical Trials (IMPAACT) Group.

In addition to funding from NICHD, funding was also provided by the National Center for Research Resources, the National Institute on Drug Abuse, and the National Institute of Mental Health.

About 200 18- to 25-year-olds on antiretroviral therapy took part in the study. Study participants included young adults taking tenofovir and those receiving other forms of anti-HIV treatment. Each month, the adolescents and young adults in the study took a 50,000-unit dose of vitamin D or placebo. At the end of the three months, parathyroid hormone levels had fallen about 14 percent among participants taking tenofovir and vitamin D but remained unchanged in participants taking other kinds of anti-HIV medication. However, youth taking tenofovir still had higher parathyroid hormone levels than those on other anti-HIV drugs. The researchers don’t know if longer treatment with vitamin D would further reduce parathyroid hormone levels.

The recommended daily dose of vitamin D is 600 units. The authors noted that they observed no adverse effects from the vitamin D treatment during the 3 months of this study.

The researchers are now making plans for a two-year follow-up study to examine the longer-term safety of vitamin D in a similar group of HIV-infected youth taking antiretroviral regimens containing , and to determine if the changes in hormone result in improvements in .

Related Stories

Vitamin D linked to reduced mortality rate in CKD

date May 07, 2008

For patients with moderate to severe chronic kidney disease (CKD), treatment with activated vitamin D may reduce the risk of death by approximately one-fourth, suggests a study in the August Journal of the American Society of ...

NIH modifies 'VOICE' HIV prevention study in women

date Sep 28, 2011

A large-scale clinical trial evaluating whether daily use of an oral tablet or vaginal gel containing antiretroviral drugs can prevent HIV infection in women is being modified because an interim review found that the study ...

Recommended for you

Indiana HIV outbreak, hepatitis C epidemic sparks US alert

date Apr 24, 2015

Federal health officials helping to contain an HIV outbreak in Indiana state issued an alert to health departments across the U.S. on Friday, urging them to take steps to identify and track HIV and hepatitis C cases in an ...

Why are HIV survival rates lower in the Deep South than the rest of the US?

date Apr 22, 2015

The Deep South region has become the epicenter of the US HIV epidemic. Despite having only 28% of the total US population, nine states in the Deep South account for nearly 40% of national HIV diagnoses. This region has the highest HIV diagnosis rates and the highest number of people living with HIV of any ...

A bad buzz: Men with HIV need fewer drinks to feel effects

date Apr 20, 2015

Researchers at Yale and the VA Pittsburgh Healthcare System compared the number of drinks that men with HIV infection, versus those without it, needed to get a buzz. They found that HIV-infected men were more sensitive to ...

Research informs HIV treatment policy for inmates

date Apr 16, 2015

A national, five-year study of care for inmates with HIV brought strangers together, produced policy change in the Delaware Department of Corrections and documented the importance of good communication and ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.