Mandina Ndona Madone, Longo- mbenza Benjamin, Renzaho Andre, Lepira Mbompaka François, Voumbo Matoumona Yolande, Mokondjimobe Etienne, Francine Ntoumi, Wumba-di-mosi Roger, Apalata Teke Ruphin, Kayembe Ntumba Jean Marie, Mambueni Thamba Christophe


Background: The artificial lightening of the skin is a social phenomenon in sub-Saharan Africa, most practiced by women using hydroquinone products, topical corticosteroids and mercury. Vitamin D is synthesized in the skin and represents the main source of the body. The use of these lighteners that determine specific skin lesions is therefore likely to cause hypovitaminosis D. HIV infection and its treatment are also a recognized risk factor for hypovitaminosis D.

Objective: This study aimed to evaluate the influence of the use and duration of lightening cosmetics, skin lesions, demographics factors, HIV status, and HAART on vitamin D concentrations.

Design: The plasma level of 25-hydroxyvitamin D [25(OH)D] (25 [OH]D < 30 ng / L= hypovitaminosis D) was measured in a cross-sectional approach, and the use and duration of use of lightening cosmetics, as well as some socio-demographic, therapeutic, and biological variables were collected from HIV infected patients and non-HIV patients in 8 hospitals from Kinshasa province, DR CONGO (DRC).

Results: 506 participants (80.2% n = 406 HIV+ and 19.8% n = 100 HIV-), were examined with 66.7% (n= 337) of hypovitaminosis D. Hypovitaminosis D was estimated 21% in HIV-, 100% in HIV+ not on HAART, and 76,5% in HIV+ not on HAART. 76.1% (n = 385) of the study population used lightening cosmetics whose 47.6% were for more than 5 years. Hypovitaminosis D was more frequent (P <0.0001) among users of lightening cosmetics (73.3% n = 297/405) than among none users of lightening cosmetics (39.6% n = 40/101). There was a very significant positive and linear association with biological gradient (P <0.0001) between increasing duration of use of cosmetics and hypovitaminosis D (39,6% in none users, 58% in 1-4 year-duration of use, 77,4% in 5-9 year-duration of use and 86,4% in ≥ 10 year-duration of use). In logistic regression, cosmetics use (OR = 3.3 95% CI 1.9-5.7, p <0.0001), advanced age (OR = 4.4 95% CI 2.7-7.2; p <0.0001), low socioeconomic status (OR = 2.2 95% CI 1.2-4, p <0.009), and HIV+ on HAART were identified significant and independent determinants of hypovitaminosis D.

Conclusions: The proportions of hypovitaminosis D and use of lightening cosmetics are epidemic in urban Congolese patients in general. The most important determinants of hypovitaminosis D were aging, lightening cosmetics, EFV and ZDV use and lower socio-economic status in these central Africans.


Vitamin D, HIV infection, lightening cosmetics, aging, EFV, ZDV Kinshasa, Central Africa.

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