Osteoporosis and vitamin D deficiency in HIV-infected patients: Genetic and classical factors compared to the HIV-associated ones – Review

Abstract

a b s t r a c tOsteopenia and osteoporosis are often found among people living with human immunodeficiency virus infection (HIV). Irrespective of age, osteopenia is found in 60% of such patients, while osteoporosis in 10-15%. Reasons for the decreased bone mineral density in this infection are diverse: possibility of osteoblast and osteoclast infection by HIV, chronic immune activation, vitamin D3 deficiency, secondary hyperparathyroidism or adverse effects of the antiretroviral treatment, and a range of others.Important factor in an osteoporosis development is related to the genetic variability. For more than 10 years genetic variants associated with bone mineralization, osteopenia and osteoporosis, mainly single nucleotide polymorphisms, have remained in the research spotlight. The most important ones identified to date include regions coding for the vitamin D3 receptor, estrogen receptors, parathyroid hormone, osteoprotegerin, type I A1 collagen and RANK/RANKL system.Vitamin D deficiency is of the primary importance not only for the adequate calcium-phosphate metabolism, but also for the regulation of the immunologic processes, cancer protection or pathogenesis of diabetes and hypertension. The most recent studies on the European and American populations confirm notable decrease of the vitamin D levels also among HIV infected patients.

The Potential Protective Role of Vitamin D Supplementation on HIV-1 Infection

“…Although the VitD deficit is widespread, people living with HIV-1 are more susceptible to hypovitaminosis D, with up to 100% prevalence reported in some HIV-1 infected cohorts across the world; a condition that has been correlated with comorbidities in seropositive individuals (9). In this population, osteopenia and osteoporosis have also been associated with hypovitaminosis D in up to 60 and 20% of infected individuals, respectively (45). Likewise, VitD may also contribute to the increased risk of cardiovascular disease (CVD) reported among HIV-1 infected patients (46).…”