Decreased bone mineral density in HIV-infected patients is independent of antiretroviral therapy

• Published in: AIDS (London) Vol. 17; no. 13; pp. 1917 - 1923
• Main Authors: BRUERA, Dario, LUNA, Norma, DAVID, Daniel O, BERGOGLIO, Liliana M, ZAMUDIO, Javier
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 05-09-2003
• Subjects: Absorptiometry, Photon; Adult; Anthropometry; Anti-HIV Agents - adverse effects; Anti-HIV Agents - therapeutic use; Biological and medical sciences; Bone Density - drug effects; Bone Diseases, Metabolic - chemically induced; Bone Diseases, Metabolic - virology; Cross-Sectional Studies; Diseases of the osteoarticular system; Female; Femur Neck - physiopathology; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - physiopathology; Human viral diseases; Humans; Infectious diseases; Lumbar Vertebrae - physiopathology; Male; Medical sciences; Middle Aged; Osteoporosis - chemically induced; Osteoporosis - virology; Osteoporosis. Osteomalacia. Paget disease; Time Factors; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Immunopathology; Diseases of the osteoarticular system; AIDS; Bone disease; Immune deficiency; Infection; Osteoporosis; Chemotherapy; Treatment; Viral disease; Antiviral; Bone mineral density; HIV infection; Osteopenia
• ISSN: 0269-9370; 1473-5571
• DOI: 10.1097/00002030-200309050-00010

To describe the alterations in the bone metabolism of HIV-seropositive patients and evaluate the effects of antiretroviral therapies.
Cross-sectional analytical study.
A total of 142 subjects (113 male, 29 female), aged 20-45 years were divided into four groups: group A, 33 HIV-seropositive antiretroviral-naive patients; group B1, 36 HIV-seropositive patients on antiviral therapy for over 1 year, without protease inhibitors (PI); group B2, 42 HIV-seropositive patients on combined therapy containing PI for over 1 year; and group C, 15 healthy, HIV-seronegative subjects. Bone mineral density (BMD) were determined by dual energy X-ray absorptiometry in total body, lumbar spine and proximal femur; and evaluation of serum osteocalcin, d-pyridinoline, parathyroid hormone (THP), calcium and phosphate, and urine calcium.
BMD was significantly lower in HIV-seropositive patients in comparison with healthy controls, in all sites studied. However, no statistical differences were observed among all groups of HIV-infected patients, independently of the antiretroviral therapy. There was a significantly higher occurrence of osteopenia and osteoporosis in HIV-infected patients in comparison with controls (P < 0.0001), with no differences among treatment-naive patients and either of the treatment groups. Bone formation and resorption markers were similar among all studied groups. There was a significant correlation in all bone sites between time of infection and BMD (P < 0.02).
BMD was significantly lower in HIV-seropositive patients in comparison with controls in lumbar spine, proximal femur and total body, without significant differences among treatment-naive patients and either of the treatment groups. Only time with HIV infection and not specific therapy was associated with BMD decreases.