Low Vitamin D is associated with coronary atherosclerosis in women with HIV

Background: Vitamin D deficiency is underdiagnosed and undertreated, especially among people living with HIV (PLWH). Recently, there has been an increased interest in the role of Vitamin D in cardiovascular disease (CVD). While Vitamin D deficiency has been associated with CVD in observational studies in the general population, there are limited data in PLWH. We therefore performed an analysis to assess the relationship of Vitamin D and coronary athAêrosclerosis using coronary CT angiography (CCTA). Methods: Women living with HIV (WLWH) without known CVD were included. Based on the median value of serum Vitamin D levels, participants were dichoto-mized to either the <25 ng/ml (lower Vitamin D group) or >25 ng/ml (higher Vitamin D group). CCTA was used to assess plaque characteristics. Results: Forty-three WLWH were included in the analyses (mean age 46 ±8 years, 56% African American, duration of HIV 15 ±6 years, 83% undetectable HIV viral load). WLWH in the lower Vitamin D group (/;=22) had significantly higher numbers of segments with any coronary plaque (2.27 ±3.01 versus 0.38 ±0.97; P=0.02) and segments with non-calcified coronary plaque (1.41 ±1.82 versus 0.29 ±0.64; P=0.03) comÂpared with WLWH in the higher Vitamin D group (/;=21). After adjusting for Framingham CHD risk point score, body mass index, diabetes and race, the relation-ship remained significant. Conclusions: Our study demonstrates a significant, indeÂpendent relationship between lower Vitamin D status and higher numbers of noncalcified coronary plaque segments in WLWH. Further studies are warranted to evaluate the effect of Vitamin D on CVD in PLWH. Trial Registration Identifier: NCT00455793.