Comprehensive Safety Monitoring of 12‐Month Daily 7000‐IU Vitamin D3 Supplementation in Human Immunodeficiency Virus–Infected Children and Young Adults

Background: There is uncertainty whether long‐term daily dosing with vitamin D₃ (cholecalciferol) supplementation (vitD₃) above the 4000‐IU/d dietary reference intake upper tolerable limit in children and adults is safe. As part of a randomized placebo‐controlled trial, we determined if supplementation with 7000‐IU/d vitD₃ for 12 months in human immunodeficiency virus (HIV)–Infected subjects was safe and/or associated with metabolic outcomes. Material and Methods: A total of 58 HIV‐infected subjects—aged 9–24.9 years and stratified by mode of HIV acquisition (perinatal or behavioral)—were recruited, randomized to 7000‐IU/d vitD₃ or placebo, and followed at 3, 6, and 12 months with physical examinations, blood and urine sampling for measures of 25(OH)D (serum 25‐hydroxyvitamin D), metabolic status, safety measures, and HIV immune status. Safety was defined by a low incidence (<5%) of the study‐defined serious adverse events—that is, elevated serum calcium plus 25(OH)D >160 ng/mL—and no changes in hematologic, liver, renal, metabolic, lipid, or inflammatory status. Results: Randomization groups did not differ in demographic characteristics, vitamin D status, or HIV disease status at baseline. Over the 12 months, serum 25(OH)D increased with supplementation. No subject experienced a serious adverse safety event; none had 25(OH)D >80 ng/mL at any time. There were no clinically significant changes in hematologic, liver, renal, metabolic, lipid, or inflammatory status. Conclusions: Safety of daily 7000‐IU vitD₃ supplementation in children and young adults with HIV was comprehensively monitored over 12 months. High‐dose daily vitD₃ supplementation was efficacious in improving vitamin D status, and there were no safety events.