Table 2.
Recommended Daily Intake of Vitamin D and Treatment Regimens for Vitamin D Deficiency in HIV-Infected Adults
Vitamin D Level | Supplementation Regimen |
>30 ng/mL | 1000 IU/day vitamin D3 |
21–29 ng/mL (insufficiency) | 2000 IU/day vitamin D3 |
15–19 ng/mL (deficiency) | Replacement: ergocalciferol 50 000 IU/week × 8 weeks (or equivalent of 6000 IU/day vitamin D3)a |
Maintenance: vitamin D3 2000 IU/dayb | |
<15 ng/mL (severe deficiency) | Replacement: Ergocalciferol 50 000 IU once or twice a week × 8–12 weeks (or equivalent of 6000 IU/day vitamin D3)a |
Maintenance: vitamin D3 2000 IU/dayb |
Abbreviation: HIV, human immunodeficiency virus.
Consider a more aggressive replacement strategy if patient has secondary hyperparathyroidism, osteomalacia, malabsorption syndrome, or obesity or is taking medications that affect vitamin D metabolism.
Recheck 25-hydroxyvitamin D level after course of ergocalciferol, goal >30 ng/mL. Consider monitoring urinary calcium in patients with a history of nephrolithiasis and concurrent calcium supplemenation use.