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HIV – recommend 100,000 IU vitamin D monthly to get levels 30 ng – May 2013

Vitamin D3 supplementation scheme in HIV-infected patients based upon pharmacokinetic modelling of 25-hydroxycholecalciferol.

Br J Clin Pharmacol. 2013 May;75(5):1312-20. doi: 10.1111/bcp.12006.
Foissac F, Tréluyer JM, Souberbielle JC, Rostane H, Urien S, Viard JP.
EA 3620 Université Paris Descartes, Sorbonne Paris Cité, France. frantz.foissac at cch.aphp.fr

AIMS: Vitamin D deficiency is prevalent in HIV-infected patients and has been associated with osteopenia and HIV disease progression. Our aims were to investigate the pharmacokinetics of 25-hydroxycholecalciferol [25(OH)D], the effect of antiretroviral treatment (ARV) and others factors that may influence the pharmacokinetics, and to determine a vitamin D3 dosing scheme to reach the 30 ng ml(-1) threshold (defined as 25(OH)D sufficiency).

METHODS: This monocentric retrospective study included 422 HIV-infected patients aged 16 to 85 years. A total of 723 25(OH)D concentrations were available for pharmacokinetic evaluation and a population pharmacokinetic model was developed with MONOLIX 3.2.

RESULTS: Median 25(OH)D at baseline was 16 ng ml(-1) (interquartile range 11-23 ng ml(-1)) for the total population, 17% of patient had concentrations below 10 ng ml(-1), 68% between 10 and 30 ng ml(-1) and 15% above 30 ng ml(-1). 25(OH)D pharmacokinetics were best described by a one compartment model with an additional endogenous production. The effects of season and skin phototype were significant on production rate. The endogenous production was 20% lower in non-white skin phototype patients and was decreased by 16% during autumn, winter and spring. No significant differences in 25(OH)D concentrations were related to antiretroviral drugs (ARV). To obtain concentrations between 30 and 80 ng ml(-1), the dosing recommendation was 100,000 IU every month.

CONCLUSIONS: Season and skin phototype had an influence on the endogenous production of 25(OH)D.
However no effect of ARV was found.
A dosing scheme to reach sufficient 25(OH)D concentrations is proposed.

© 2012 The Authors. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society.

PMID: 23072545, [PubMed - indexed for MEDLINE]
PMC3635601 [Available on 2014/5/1]

Note by VitaminDWiki
The 100,000 IU vitamin D monthly will most likely get most of patients to > 30ng
Study states that this does not interfer with antiretroviral drug treatment of HIV
It does not speculate or indicate if this is enough to treat HIV.

See also VitaminDWiki

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