HIV associated hypocalcaemia among diarrheic patients in northwest Ethiopia: a cross sectional study

Abstract

BackgroundHypocalcaemia, defined by serum calcium level less than 8.5 mg/dl, could be caused by human immunodeficiency virus (HIV) and diarrheal diseases. In Ethiopia, while morbidities from diarrheal diseases and HIV are serious health problems, studies assessing the interactions amongst of the three do not exist. Therefore, the present study was undertaken to investigate the level of calcium among diarrheic patients with and without HIV co-infection.MethodsConsecutive diarrheic patients attending Gondar University Hospital in Ethiopia were enrolled and screened for HIV, intestinal parasites, Shigella and Salmonella. Concentration of calcium in serum was determined using an inductively coupled plasma mass spectrometer.ResultsA total of 206 diarrheic patients were included in the study (109 = HIV positive, 97 = HIV negative). Intestinal parasites and Shigella species were detected in 32.2% and 8.5% of the patients, respectively. The serum calcium levels in the patients who were found positive for Shigella species or intestinal parasites was not significantly different by the presence or absence of HIV co-infection. HIV infected diarrheic patients had significantly lower mean serum calcium levels (7.82 ± 1.23 mg/dl) than those negative for HIV (8.38 ± 1.97) (P = 0.015). The age groups 25–35 and greater than 45 years showed significantly lower mean serum calcium levels (7.77 ± 1.55 mg/dl) in comparison to the other age groups (7.84 ± 1.41 mg/dl, P = 0.009). On the other hand, females presented with significantly lower mean serum calcium levels (7.79 ± 1.60 mg/dl, P = 0.044) than males (8.26 ± 1.65 mg/dl).ConclusionThere is high prevalence of hypocalcaemia among diarrheic patients in northwest Ethiopia. And HIV stood out to be a major risk factor for development of hypocalcaemia among the diarrheic patients in northwest Ethiopia. Further studies are required to substantiate and characterize the mechanisms and consequences of calcium metabolism disorders among HIV infected individuals in the study area.

25 (OH) Vitamin D level and Calcium/Phosphorus Metabolism Disorders in Patients Living with HIV in Abidjan

“…Therefore, there will be no distribution of calcium from the cell into the blood [15]. The inflammatory process due to virus replication causes hypocalcemia [16].…”

“…Hyperphosphatemia is due to the low serum parathyroid hormone (PTH) level and the inhibitory action of the FGF-23 on the α-1-hydroxylase. There will be no phosphate reabsorption in the proximal tubule [15]. However, certain antiviral molecules involving nucleotide analogs to nucleoside analogues can cause damage and kidney dysfunction, which leads to the reduction of the phosphorus filtration rate in the kidney thus raising its level in the blood serum [17].…”

Circulating 25-hydroxycholecalciferol and calcium levels, and alkaline phosphatase activity among people living with and without human immunodeficiency virus and injecting drugs in kenya

“…Hypocalcaemia is common in HAART-naive and -experienced PLHIV [ 52 , 53 ]. Consistent with previous findings, our study found lower median serum calcium levels in PLHIV HAART-experienced PWID.…”

Severe hypocalcemia due to hypoparathyroidism associated with HIV: A case report

“…The mechanism of Tenofovir-associated hypophosphatemia is both renal Fanconi syndrome as well as an increase in FGF23. Recent studies have shown increased prevalence of hypocalcemia in PLWH due to a high prevalence of vitamin D deficiency ( Moges et al, 2014 ; Kuehn et al, 1999 ).…”