Evaluation of Calcium Levels Among HIV Patients Attending RSUTH: ART- Naïve Versus ART Experienced

Calcium is an essential mineral involved in bone metabolism, neuromuscular function, and intracellular signaling. HIV infection and antiretroviral therapy (ART) have been associated with disturbances in mineral metabolism and reduced bone health. This study estimated serum calcium levels in ART naïve and ART treated HIV subjects attending the Rivers State University Teaching Hospital, Port Harcourt, Nigeria, and examined effects of sex, ART duration, regimen and lifestyle factors A cross-sectional study design was employed, involving 180 participants (120 HIV-positive and 60 HIV-negative as controls) within the age range of 18-60 years. Serum calcium was determined by the O-cresolphthalein complexone colorimetric method. Group comparison using one –way ANOVA with Tukey's post hoc test (Graph pad prism version 9.0.0, 121). Results with values of P< 0.05 was considered significant. Results showed a decline in mean serum calcium levels across the three groups (control, ART-naïve and ART treated). Control males had higher calcium than Control females (9.69 ± 0.44 mg/dl: 9.22 ± 0.39 mg/dl; p = 0.0045). ART-naïve patients had reduced calcium (males: 8.47 ± 0.55; females: 8.23 ± 0.43 mg/dl), ART users exhibited the lowest levels (males: 6.34 ± 0.73; females: 6.55 ± 0.67 mg/dl; p<0.0001 across groups), Longer ART duration correlated with progressively lower calcium (approximately 7.16 mg/dl at 3 months to 5.55 mg/dl beyond 6 months; p < 0.05). ART regimen did not affect males but in female’s calcium was higher in subjects on TDF+3TC+DTG versus TDF+3TC+EFV (7.05 ± 0.64 mg/dl vs 6.13 ± 0.49 mg/dl; p = 0.0126). Lifestyle factors showed no significant association. HIV infection and ART especially on longer duration are associated with significant reductions in serum calcium. Routine monitoring and appropriate nutritional supplementation, therapeutic interventions or regimen choice are recommended to mitigate potential bone-related complications.