Calcium carbonate and vitamin D for bone density in adolescents with HIV
What it found
In adolescents with HIV, taking calcium carbonate and high-dose vitamin D for 48 weeks made no difference to bone density overall.
Among those who started with low vitamin D, the supplements improved spine bone density.
What they found
Studies in people
Bone density overall
At 48 weeks, total body bone density and spine bone density were about the same in both groups. The authors found no difference between those taking the supplements and those taking the placebo.
Low vitamin D at start
Among the 639 participants who started with vitamin D insufficiency, those taking the supplements had a higher spine bone density score than those taking the placebo. The difference was small.
Side effects
No severe side effects related to the drugs were seen.
Vitamin D insufficiency
Most participants, 639 out of 842, had low vitamin D at the start of the study.
What the authors conclude
“High-dose vitamin D 3 and calcium supplementation, a safe and cheap intervention, during adolescence might promote bone accrual and mineralisation in those with vitamin D insufficiency, which could increase peak bone mass.”
Also in their conclusions
- They conclude that overall there was no difference in bone density between the groups.
- They say that among those with vitamin D insufficiency, the supplements improved bone density.
- They suggest that high-dose vitamin D3 and calcium, a safe and cheap intervention, during adolescence might promote bone accrual and mineralisation in those with vitamin D insufficiency, which could increase peak bone mass.
How it was done
HIV harms bone development in children even when they take antiretroviral therapy. The authors wanted to see whether extra vitamin D and calcium could help.
They studied 842 adolescents aged 11 to 19 with HIV acquired from their mothers, recruited from clinics in Harare, Zimbabwe and Lusaka, Zambia. Participants took either 20 000 IU vitamin D3 weekly plus 500 mg calcium carbonate daily, or a placebo, for 48 weeks. Bone density was measured at the start and end.
What it can’t tell you
- We summarised it from the abstract only.
- This study was in adolescents with HIV, so the results may not apply to other groups.
- It can show a link between the supplements and bone density, but not prove cause and effect.
- The long-term effects on fracture risk are not known.
Who paid
- Conflicts
- Declaration of interests We declare no competing interests.
- Authors work at
- UK; Biomedical Research and Training Institute, Zimbabwe; Biomedical Research and Training Institute, Zimbabwe; University Teaching Hospital, Zambia
The paper
- Title
- Impact of high-dose vitamin D and calcium carbonate supplementation on bone density in adolescents living with HIV: a randomised, placebo-controlled trial
- Type
- Randomised controlled trial
- Evidence
- Studies in people
- Summarised from
- Abstract only
- Cite
- Ferrand RA, Dzavakwa NV, Bandason T, et al (2026). Impact of high-dose vitamin D and calcium carbonate supplementation on bone density in adolescents living with HIV: a randomised, placebo-controlled trial. The Lancet. Child & adolescent health. doi:10.1016/S2352-4642(25)00301-3PubMed 41391456DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error