Vitamin D and bone loss in HIV

Curr Opin HIV AIDS. 2016 May;11(3):277-84. doi: 10.1097/COH.0000000000000272.


Purpose of review: Bone health has become an increasingly important aspect of the care of HIV-infected patients as bone loss with antiretroviral therapy (ART) initiation is significant and osteopenia and osteoporosis are highly prevalent. Vitamin D is tightly linked to calcium balance and bone health, and vitamin D deficiency is common in HIV. This review outlines the epidemiology of vitamin D deficiency in HIV, summarizes our current understanding of the relationship between vitamin D and bone loss in HIV and the impact of vitamin D supplementation in this patient group.

Recent findings: Although data are conflicting as to whether vitamin D deficiency is more prevalent among HIV-infected individuals than in the general population, there are several reasons for why this patient group may be at heightened risk. Studies linking vitamin D deficiency to bone loss in HIV are limited; however, data from randomized clinical trials suggest a benefit of vitamin D supplementation for the prevention of bone loss with ART initiation and for the treatment of bone loss with bisphosphonate therapy.

Summary: There are too limited data to recommend universal screening of vitamin D status or supplementation to all HIV-infected individuals. However, testing 25-hydroxyvitamin D levels in those at risk for deficiency and treating patients found to be deficient or initiating ART or bisphosphonate therapy should be considered. Further study on vitamin D supplementation is needed regarding the potential benefit on immune activation and restoration in this patient group.

Trial registration: NCT01523496.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Bone Diseases, Metabolic / complications
  • Bone Diseases, Metabolic / prevention & control*
  • Fractures, Bone / prevention & control*
  • HIV Infections / complications
  • HIV Infections / drug therapy*
  • Humans
  • Osteoporosis / complications
  • Osteoporosis / prevention & control*
  • Vitamin D / therapeutic use*


  • Vitamin D

Associated data