J Kermanshah Univ Med Sci. 2018 June; 22(2):e81668.
Published online 2018 August 28.
doi: 10.5812/jkums.81668.
Research Article
Serum Levels of Vitamin D, Magnesium, Calcium, Iron, and TIBC in
HIV-Infected Patients
Alireza Janbakhsh
1
, Feizollah Mansouri
1
, Siavash Vaziri
1
, Babak Sayad
1
, Mandana Afsharian
1, *
and
Ronak Miladi
1
1
Department of Infectious Disease, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
*
Corresponding author: Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran. Tel: +98-8334276315, Email: mandanaafsharian@yahoo.com
Received 2018 May 26; Accepted 2018 July 03.
Abstract
Background: Vitamin D insufficiency and HIV infection are both risk factors for chronic disorders. Several studies on small groups
of male HIV-infected patients have reported alterations of calcium and bone metabolisms. This study aimed to evaluate serum levels
of vitamin D, magnesium, calcium, iron, and TIBC in HIV-infected patients compared with controls in the west of Iran.
Methods: In a case-control study approved by the Ethics Committee of Kermanshah University of Medical Sciences, 98 prisoners
with HIV and 98 controls were selected in 2016. Age, sex, vitamin D, calcium, magnesium, iron and total iron binding capacity (TIBC)
were checked for all participants in both groups. Also, CD4 was checked in all HIV-infected patients.
Results: The mean age ± SD (range) of HIV-infected and control groups was 40.11 ± 7.73 (21.68) and 45.59 ± 18.61 (18.85) years, re-
spectively. Vitamin D, calcium, iron, and TIBC levels were significantly different in these two groups (P < 0.05). Vitamin D deficiency
was higher in the HIV-infected group than that in the control group. Furthermore, calcium, iron and TIBC levels were higher in the
HIV-infected group compared with those in the control group.
Conclusions: This study showed that calcium, iron and TIBC levels were significantly higher in HIV-infected patients compared with
those in the control group. Moreover, vitamin D insufficiency and deficiency were higher in HIV-infected patients. The patients with
CD4 < 200 cells/mm
3
had less calcium and iron levels compared with 200 - 500 and > 500 cells/mm
3
.
Keywords: Vitamin D, Magnesium, Calcium, Iron, TIBC, HIV
1. Background
HIV infects cluster of differentiation 4 (CD4) T-
lymphocytes, monocytes, and macrophages. As a result of
this infection, the number and function of CD4 cells are
reduced and both cell-mediated and humoral immunity
are affected (1). HIV prevalence is increasing worldwide
because people on antiretroviral therapy live longer. Nev-
ertheless, new infections have decreased from 3.3 million
in 2002 to 2.3 million in 2012. Global AIDS-related deaths
peaked at 2.3 million in 2005 has decreased to 1.6 million
by 2012. An estimated 9.7 million people in low-income
and middle-income countries had started antiretroviral
therapy by 2012 (2). According to a systematic review and
meta-analysis in Iran from January 1996 to March 2012, HIV
prevalence varied from 0.00% in the general population to
17.25% in injecting drug users (3). The number of persons
living with HIV worldwide reached approximately 35.3
million in 2012 (4).
Vitamin D deficiency is a very common disorder, afflict-
ing both Western and developing countries (5). Vitamin
D insufficiency and HIV infection are both risk factors for
chronic disorders; so, it is important to consider vitamin
D status in HIV-infected patients (6). Vitamin D deficiency
has been associated with an increased risk of falls and frac-
tures, diabetes and obesity, cardiovascular disease, some
malignancies, and tuberculosis (5, 7, 8). Alterations of cal-
cium and bone metabolisms have been reported in several
studies on small groups of male HIV-infected patients (9).
Iron deficiency is the leading cause of anemia in the de-
veloping world (10). Anemia is a common clinical finding
in HIV-infected patients. In this regard, iron deficiency or
redistribution may contribute to the development of low
hemoglobin levels (11).
The aim of this study is to evaluate serum levels of vita-
min D, magnesium, calcium, iron, and TIBC in HIV-infected
patients compared with healthy people (i.e., controls) in
the West of Iran.
2. Methods
In a case-control study approved by the Ethics Com-
mittee of Kermanshah University of Medical Sciences, 98
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