Vitamin D and statin associated myalgia in HIV infection

545 Italian HIV-infected patients were prescribed atorvastatin (55.8%) or rosuvastatin (44.2 %). After a mean duration of therapy of 29 months 42 patients were diagnosed with myalgia and 25 had increased creatine kinase levels and myalgia. In patients with myalgia the mean concentration of 25-hydroxivitamin D was significantly lower compared to patients without myalgia. Patients without myalgia had a mean concentration of 32.1 ng/ml compared to 19.4 ng/ml in patients with myalgia and 22.8 ng/ml in patients with myalgia and elevated creatine kinase. Old age and longer duration of therapy was associated with increased risk of myalgia.

Calza et al. AIDS 2017;31:681-688

Comment: Both Vitamin D deficiency and treatment with statins are common in HIV-positive patients. This study was performed in sunny Italy. One may suspect that vitamin D deficiency is more
common in places with less sun exposure. It seems reasonable to screen for vitamin D deficiency in patients with myalgia on statin therapy.