Osteomalacia in an HIV-infected man due to rifabutin treatment
Author Information
Author(s): Mark J Bolland, Andrew Grey, Anne M Horne, Mark G Thomas
Primary Institution: University of Auckland
Hypothesis
Treatment with rifabutin led to the induction of cytochrome P450 enzymes catabolising vitamin D, thereby causing vitamin D deficiency and osteomalacia.
Conclusion
Treatment with rifabutin induces the cytochrome P450 enzymes that metabolise vitamin D and patients treated with rifabutin might be at increased risk of vitamin D deficiency.
Supporting Evidence
- The patient had vitamin D deficiency and secondary hyperparathyroidism before starting rifabutin.
- After treatment with rifabutin, the patient developed worsening vitamin D deficiency and osteomalacia.
- High doses of vitamin D were required to correct the deficiency and improve the patient's condition.
Takeaway
A man with HIV got weak bones because a medicine he took made it hard for his body to use vitamin D, which is important for strong bones.
Methodology
The case study involved monitoring the patient's vitamin D levels and bone health over time while he was treated with various medications.
Limitations
The study is based on a single case, which may not be generalizable to all patients.
Participant Demographics
A 59-year-old Sri Lankan man with a history of HIV and other health issues.
Digital Object Identifier (DOI)
Want to read the original?
Access the complete publication on the publisher's website