Effectiveness of supplementation with different doses of calcifediol in HIV patients with vitamin D deficiency

Abstract

Background

People with HIV (PWH) often exhibit vitamin D deficiency, with ambiguous treatment guidelines. This study evaluates the effectiveness of three vitamin D3 calcifediol supplementation regimens over 48 weeks, aiming to identify patients whose serum levels do not increase above 20 ng/mL.

Methods

In this prospective observational study, 112 HIV-positive outpatients with 25OHD levels below 20 ng/mL were assigned to one of three supplementation groups. Group 1 received 16,000 IU weekly for 12 weeks, then biweekly; Group 2 received 180,000 IU every 12 weeks; Group 3 received 180,000 IU every 4 weeks for the first 12 weeks, then every 12 weeks. The groups were compared using ANOVA and Chi-squared tests.

Results

The average participant age was 51.59 years, with 71.4% being male, all on antiretroviral therapy for an average of 9.5 years. By week 48, Group 1 showed the lowest percentage of patients with levels below 20 ng/mL (10.2%), significantly outperforming Group 2 (44%) and Group 3 (31.6%). Vitamin D levels significantly increased in Groups 1 and 3, with no significant change in calcium, phosphorus and bone density between groups. The CD4:CD8 ratio increased significantly in all groups. No side effects were observed.

Conclusions

The regimen of 16,000 IU calcifediol weekly for 12 weeks followed by biweekly dosing is both safe and effective for PWH, significantly increasing vitamin D levels and improving the CD4:CD8 ratio without adverse effects.