Background and aims Vitamin D deficiency is high amongst children with perinatally acquired HIV infection. Increased life expectancy for HIV patients requires increased focus on long term bone health. Early diagnosis and treatment of vitamin D deficiency aids prevention of diseases such as rickets and osteomalacia. We aimed to audit the management of vitamin D deficiency in HIV positive children at Leicester Children’s Hospital.
Method Notes of patients aged <18 years who are HIV positive (30 patients) and biochemistry software were used to assess the diagnosis and treatment of vitamin D deficiency in the last 12 months. Risk factors including BMI, ethnicity, bone profile and antiviral treatment were also noted. Results were then compared to guidelines from St Mary’s Hospital, Imperial College Healthcare Trust.
Results 96% (29 patients) were of Afro-Caribbean or South-Asian ethnicity, with the majority from Sub-saharan Africa. 93% (28 patients) had vitamin D levels checked within the last 12 months, and 54% of patients were deficient (<50 nmol/l). Of these, 75% were treated adequately. Only 30% had post-therapeutic vitamin D levels checked, and none had explicit winter maintenance doses administered.
Conclusions Given the ethnicity of the majority of patients, vitamin D deficiency is fairly common and at times, severe. Rates of vitamin D deficiency identification and treatment were high. Following up post-treatment and providing a winter maintenance dose were areas where the Paediatric department fell short. A structured approach with routine blood tests and introduction of a standard winter prophylactic dose may lead to an improvement in this.