In:
Clinical Infectious Diseases, Oxford University Press (OUP), Vol. 73, No. 9 ( 2021-11-02), p. 1555-1564
Abstract:
To evaluate the impact of vitamin D and calcium supplementation (VitD/Ca) on lumbar spine bone mineral density (LSBMD) and bone metabolism among Thai adolescents with perinatally acquired HIV (PHIVA). Methods A multicenter, randomized, active-control, open-labeled trial was conducted. PHIVA (aged 10–20 years) who were on stable cART were enrolled. Baseline LSBMD status was defined as low (z-score ≤ −2) and normal ( & gt; −2). Eligible PHIVA were randomly assigned to receive standard-dose (400 IU/1200 mg/day) or high-dose (400 IU/1200 mg/day plus ergocalciferol 20 000 IU/week) VitD/Ca supplementation for 48 weeks (ratio 1:1, stratified by baseline LSBMD). Study outcomes were changes in LSBMD, LSBMD z-scores, and bone metabolism–related biomarkers (25-hydroxyvitamin D [25(OH)D], intact parathyroid hormone [iPTH] , C-terminal telopeptide [CTX], procollagen type I amino-terminal propeptide [PINP] ) from baseline to week 48. Results Among 200 enrolled PHIVA, median age was 16 (IQR:14–18) years; 61% were on NNRTI-based cART. Median 25(OH)D level was 25.5 (IQR: 20.8–33.0) ng/mL. After 48-week VitD/Ca supplementation, LSBMD significantly increased in both treatment groups (high-dose: median: +0.07 [IQR: +0.04 to +0.11] g/cm2; P & lt; .001; standard-dose: +0.09 [+0.03 to +0.13] g/cm2; P & lt; .001). Notably, the change in LSBMD z-scores was significantly greater in high-dose versus standard-dose groups (median: +0.4 [IQR: −0.1 to +0.9] vs +0.1 [−0.4 to +0.7] ; P = .02). Levels of 25(OH)D increased, whereas iPTH, CTX, and PINP declined significantly in both groups (P & lt; .05), but no between-group differences were demonstrated. Conclusions Over 48-week VitD/Ca supplementation, significant increases in LSBMD, and significant decreases in bone metabolism–related markers were observed among our Thai PHIVA in both treatment groups. The improvement in LSBMD z-score was more enhanced with high-dose VitD/Ca supplementation than standard-dose. High-dose VitD/Ca supplementation might be considered to promote bone health in this population. Clinical Trials Registration NCT02426840.
Type of Medium:
Online Resource
ISSN:
1058-4838
,
1537-6591
Language:
English
Publisher:
Oxford University Press (OUP)
Publication Date:
2021
detail.hit.zdb_id:
2002229-3
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