Vitamin D deficiency and its associated factors among HIV patients at Mbarara City Health Centre IV, south-western Uganda

Abstract

Background: HIV is a global health challenge. Despite increased life expectancy because of antiretroviral therapy, vitamin D deficiency (VDD) remains widespread among HIV-positive individuals. Factors such as poor nutrition, limited sunlight exposure, and certain medications, contribute to high VDD rates. Despite this, the magnitude of this problem is not well documented in our setting. Objective: The purpose of this study was to determine the prevalence and factors associated with VDD among HIV patients in south-western Uganda. Methods: This cross-sectional study at Mbarara City Health Centre IV involved 218 randomly selected HIV patients on antiretroviral therapy. Data were collected through structured questionnaires, medical records review, and blood samples for biochemical analysis. VDD was defined as serum levels < 25 ng/mL. Levels of ˃ 5 mg/L for C-Reactive Protein (CRP) were considered elevated. Body mass index (BMI) was categorised as < 25 kg/m2 normal, 25–29.9 kg/m2 overweight, and ≥ 30 kg/m2 for obese. Statistical analysis included descriptive statistics and logistic regression to assess factors associated with VDD. Results: The median age of the participants was 38 years (interquartile range 30–45) with most being female (163, 74.8%). Of the 218 study participants, 66 had Vitamin D levels < 25 ng/mL, giving a prevalence of VDD of 30.3% (95% CI: 24.51% – 36.73%). Being overweight, obese, and having a CRP level of > 5 mg/L, were significantly associated with VDD. Conclusion: The study found a 30.3% prevalence of VDD among HIV-positive individuals at Mbarara City Health Centre IV. Key associated factors included higher BMI and elevated CRP levels. What this study adds: This study highlights the significant burden of VDD among HIV positive individuals in a Ugandan setting, with a prevalence of 30.3%. It identifies obesity and elevated CRP levels as key risk factors, emphasizing the need for integrated nutritional and inflammatory monitoring in HIV care.