Vitamin D deficiency is associated with non-alcoholic fatty liver disease (NAFLD) in virally suppressed people with HIV, according to a study conducted in Italy. The findings suggest a relationship between vitamin D deficiency and NAFLD similar to the one seen in general-population studies.
About This Study
“Relationship between vitamin D deficiency and non-alcoholic fatty liver disease in patients with HIV-1 infection“ was published online on Dec. 11, 2023, in Journal of Acquired Immune Deficiency Syndromes. The lead author is Leonardo Calza, M.D., of the Unit of Infectious Diseases at the Department of Medical and Surgical Sciences of the “Alma Mater Studiorum” University of Bologna, Italy, and its IRCCS S. Orsola Hospital.
Key Research Findings
This retrospective single-site study in Italy evaluated vitamin D levels and liver steatosis in 413 virally suppressed people living with HIV. Data were collected in 2021. Most participants were middle-aged men (79% of participants male, 97% of participants Caucasian, mean age 52 years).
Forty-three percent of participants had serum vitamin D concentrations <20 ng/mL, indicating deficiency, and 57% of participants had sufficient vitamin D levels. Based on a liver elastography scan, 33% of participants were diagnosed with non-alcoholic fatty liver disease, defined as a controlled attenuation parameter of ≥238 dB/m. Antiretroviral therapy regimens included tenofovir alafenamide in 52% of participants, while 19% of participants were on a dolutegravir-based regimen.
In both uni- and multivariate models, the liver disease was more common in participants who were vitamin D-deficient. Vitamin D deficiency was also associated with hypertension, overweight or obesity (body mass index >25 kg/m2, waist circumference >90 cm), metabolic issues (metabolic syndrome, high triglycerides), and reduced bone mineral density.
Discussion Highlights and Implications for Practice
Study limitations reported included its retrospective design and data abstracted from medical records.
Researchers pointed out that this study’s results indicate a significant association between low vitamin D levels and non-alcoholic fatty liver disease and associated risk factors in people living with HIV.