Ultraviolet Index and Location are Important Determinants of Vitamin D Status in People with Human Immunodeficiency Virus

This study aimed to document the vitamin D status of HIV‐infected individuals across a wide latitude range in one country and to examine associated risk factors for low vitamin D. Using data from patients attending four HIV specialist clinics across a wide latitude range in Australia, we constructed logistic regression models to investigate risk factors associated with 25(OH)D < 75 nmol L −1 . 1788 patients were included; 87% were male, 76% Caucasian and 72% on antiretroviral therapy. The proportion with 25(OH)D < 50 nmol L −1 was 27%, and <75 nmol L −1 was 54%. Living in Melbourne compared with Cairns (adjusted odds ratio ( aOR ) 3.30; 95% CI 2.18, 4.99, P  <   0.001) and non‐Caucasian origin ( aOR 2.82, 95% CI 2.12, 3.75, P  <   0.001) was associated with an increased risk, while extreme UV index compared with low UV index was associated with a reduced risk ( aOR 0.33; 95% CI 0.20, 0.55, P  <   0.001) of 25(OH)D < 75 nmol L −1 . In those with biochemistry available ( n  = 1117), antiretroviral therapy was associated with 25(OH)D < 75 nmol L −1 ; however, this association was modified by serum cholesterol status. Location and UV index were the strongest factors associated with 25(OH)D < 75 nmol L −1 . Cholesterol, the product of an alternative steroid pathway with a common precursor steroid, modified the effect of antiretroviral therapy on serum 25(OH)D.