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Retrospective cohort study finds elevated serum calcium correlates with liver disorders in HIV-positive individuals, suggesting nutritional strategies.
BACKGROUND: Liver disease remains a major cause of non-AIDS-related morbidity and mortality in people living with HIV (PLWH). Calcium homeostasis is involved in multiple hepatic processes, but the clinical relationship between serum calcium and liver injury in PLWH remains unclear. METHODS: We conducted a retrospective longitudinal cohort study incorporating repetitive measurements and proteomic analysis. Associations between serum calcium and liver disorders were assessed using logistic regression, Cox regression, and piecewise linear regression models. Unadjusted models and Kaplan-Meier analysis showed consistent results. Proteomic analysis identified F5, GDI2, and LDHA significantly associated with both serum calcium and liver function, enriched in coagulation and glycolysis pathways. CONCLUSIONS: Elevated serum calcium at combined antiretroviral therapy (cART) initiation strongly correlates with subsequent liver disorders in PLWH with Ca × 2 ≥ 4.52, potentially involving dysregulated coagulation and glycolysis pathways. These reference levels can guide assessment of calcium intake strategies in PLWH.
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Liu et al. (2026) studied this question.
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