The effect of cholecalciferol and calcitriol on biochemical bone markers in HIV type 1-infected males: results of a clinical trial

AIDS Res Hum Retroviruses. 2013 Apr;29(4):658-64. doi: 10.1089/AID.2012.0263. Epub 2013 Jan 11.

Abstract

HIV-1-infected patients have an increased risk of osteoporosis and fractures. The main objective of this study was to evaluate the bone metabolism in HIV-1-infected patients exposed to calcitriol and cholecalciferol. We also investigated the relationship between T cells and bone markers. We conducted a placebo-controlled randomized study running for 16 weeks including 61 HIV-1-infected males, of whom 51 completed the protocol. Nineteen participants were randomized to daily treatment with (A) 0.5-1.0 μg calcitriol and 1,200 IU (30 μg) cholecalciferol, 17 participants to (B) 1,200 IU cholecalciferol, and 15 participants to (C) placebo. At baseline and after 16 weeks, we determined collagen type 1 trimeric cross-linked peptide (CTx), procollagen type 1 N-terminal peptide (P1NP), parathyroid hormone (PTH), ionized calcium, 25-hydroxyvitamin D (25OHD), and 1,25-dihydroxyvitamin D [1,25(OH)2D]. We determined naive CD4(+) and CD8(+), activated CD4(+) and CD8(+), and regulatory CD4(+)CD25(+)CD127(low) T lymphocytes. Baseline levels of P1NP and CTx correlated (coefficient 0.5, p<0.001) with each other but not with PTH, 25OHD, or 1,25(OH)2D. In patients receiving calcitriol and cholecalciferol, the mean levels of P1NP (p<0.001) and CTx (p= 0.002) declined significantly compared to our placebo group. Based on changes in P1NP and CTx, we estimated that net bone formation occurred more frequently in group A compared to groups B and C. PTH correlated inversely with naive CD4(+) and CD8(+) cells. Otherwise, no relationships between bone markers and T lymphocytes were demonstrated. Supplementation with calcitriol and cholecalciferol induced biochemical indications of bone formation in HIV-1 patients.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers / blood
  • Bone Density Conservation Agents / administration & dosage*
  • Bone and Bones / drug effects*
  • Bone and Bones / metabolism*
  • Calcitriol / administration & dosage*
  • Calcium / blood
  • Cholecalciferol / administration & dosage*
  • Collagen Type I / blood
  • Double-Blind Method
  • HIV Infections / drug therapy*
  • HIV Infections / immunology
  • HIV Infections / metabolism*
  • HIV-1*
  • Humans
  • Male
  • Middle Aged
  • Osteogenesis / drug effects
  • Parathyroid Hormone / blood
  • Peptide Fragments / blood
  • Peptides / blood
  • Procollagen / blood
  • Prospective Studies
  • T-Lymphocyte Subsets / drug effects
  • T-Lymphocyte Subsets / immunology
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood

Substances

  • Biomarkers
  • Bone Density Conservation Agents
  • Collagen Type I
  • Parathyroid Hormone
  • Peptide Fragments
  • Peptides
  • Procollagen
  • collagen type I trimeric cross-linked peptide
  • procollagen Type I N-terminal peptide
  • Vitamin D
  • Cholecalciferol
  • 1,25-dihydroxyvitamin D
  • 25-hydroxyvitamin D
  • Calcitriol
  • Calcium