Abstract:

Background: A high prevalence of Vitamin D Deficiency has been reported in children living with HIV even in countries with abundant sunlight throughout the year. Vitamin D is a potent immune modulator of innate and adaptive immunity responses via its receptors on CD4 cells. This study aimed to assess the prevalence and the factors associated with vitamin D deficiency in children living with HIV on ART attending the pediatric HIV clinic at Bugando Medical Center, Mwanza.

Methodology: A cross-sectional hospital-based study among children aged between 6 months and 5 years living with HIV on ART attending the BMC pediatric HIV clinic was conducted from January to March 2024. Serum 25 hydroxyvitamin D (25(OH)D) was measured using the electrochemiluminescence method. Vitamin D deficiency was defined as serum levels < 30ng/ml. Anthropometry, physical exam, and medical history were documented. Logistic regression was performed.

Results: 200 children were enrolled with a median age of 36 (20-49) months. Of all participants, 55 (27.5%) were stunted while only 6 (3%) showed clinical signs of rickets. Most participants were virologically suppressed (VL< 1000 copies/ml). Vitamin D Deficiency was observed in 13 (6.5%) participants with independent associations found with stunting (AOR 6.1, 95% CI (1.3- 32.1), p = 0.036), and the presence of clinical signs of rickets (AOR 184, 95% CI (12.0-98.2), p = 0.001).

Conclusion and recommendations: The prevalence of Vitamin D deficiency among children living with HIV is lower than previously reported. Clinical signs of rickets and stunting increase the odds of deficiency, hence monitoring for serum Vitamin D levels is necessary in children with these clinical signs.