Skip to content
2000
Volume 22, Issue 4
  • ISSN: 1570-162X
  • E-ISSN:

Abstract

Introduction/Objectives

Different ART (antiretroviral therapy) options may affect the risk of osteopenia/osteoporosis in people living with HIV (PLWH) having increased life expectancy. Current guidelines recommend bone mineral density (BMD) measurement only in patients at risk. In our study, we investigated the prevalence of osteopenia/osteoporosis and associated risk factors in naive patients not receiving ART.

Methods

This study included 116 newly diagnosed, ART naive HIV-positive patients who were studied retrospectively. Vitamin D level, BMD measurement, CD4 and CD8 count, CD4/CD8 ratio, HIV RNA level, body mass index and other risk parameters of ART naive patients were included in our study.

Results

Of 116 patients, 103 were male and 13 female. 47.4% (osteoporosis in 4.3%, osteopenia in 43.1%) of patients had osteopenia/osteoporosis. The patients with osteopenia/osteoporosis had older age (39.2±11.0 32.0±8.6, =0.0001), lower vitamin D levels (16.0±5.0 24.4±6.3, =0.0001), lower BMI (body mass index) (23.0±4.0 24.6±4.6 <0.05), lower CD4 and CD8 counts (405.1±885.0 467.3± 695.1; 849.9570.4 1012.0±629.4, respectively, <0.05). 41.8% had CD4 count ≤200/µL ( 18.0%, =0.005). No statistically significant differences were observed in terms of gender distribution, smoking, alcohol and drug use, comorbidities and, additional drug use and HIV RNA >100 000 copies/ml. In multivariate analysis, age and vitamin D level were significant and independent (<0.05) risk factors with osteoporosis/osteopenia.

Conclusion

Being over 40 years of age, CD4 count ≤200/µL, vitamin D level <20 ng/mL and low BMI are the most important risk factors for osteopenia/osteoporosis in ART naive patients. Among these parameters, age and vitamin D level were significant and independent risk factors. These factors may guide the determination of the need for dual-energy x-ray absorptiometry (DXA) testing in ART naive patients and drug choices in the treatment plan.

Loading

Article metrics loading...

/content/journals/chr/10.2174/011570162X311238240603042806
2024-07-01
2024-11-19
Loading full text...

Full text loading...

References

  1. AlvarezE. BellosoW.H. BoydM.A. InkayaA.Ç. HsiehE. KambuguA. KaminskiG. MartinezE. StellbrinkH.J. WalmsleyS. BrownT.T. MallonP.W.G. Which HIV patients should be screened for osteoporosis.Curr. Opin. HIV AIDS201611326827610.1097/COH.000000000000026926895510
    [Google Scholar]
  2. ShiauS. BrounE.C. ArpadiS.M. YinM.T. Incident fractures in HIV-infected individuals.AIDS201327121949195710.1097/QAD.0b013e328361d24124126140
    [Google Scholar]
  3. CotterA.G. SabinC.A. SimelaneS. MackenA. KavanaghE. BradyJ.J. McCarthyG. CompstonJ. MallonP.W.G. Relative contribution of HIV infection, demographics and body mass index to bone mineral density.AIDS201428142051206010.1097/QAD.000000000000035325265073
    [Google Scholar]
  4. AntelaA. AguiarC. CompstonJ. HendryB.M. BoffitoM. MallonP. Pourcher-MartinezV. Di PerriG. The role of tenofovir alafenamide in future HIV management.HIV Med.201617S2Suppl. 241610.1111/hiv.1240126952360
    [Google Scholar]
  5. PramuktiI. LindayaniL. ChenY.C. YehC.Y. TaiT.W. FetzerS. KoN.Y. Bone fracture among people living with HIV: A systematic review and meta-regression of prevalence, incidence, and risk factors.PLoS One2020156e023350110.1371/journal.pone.023350132497105
    [Google Scholar]
  6. EACSGuidelines version 12.0 October 2023.2023Available From: https://www.eacsociety.org/media/guidelines-12.0.pdf
  7. BiverE. Osteoporosis and HIV infection.Calcif. Tissue Int.2022110562464010.1007/s00223‑022‑00946‑435098324
    [Google Scholar]
  8. BorgströmF. KarlssonL. OrtsäterG. NortonN. HalboutP. CooperC. LorentzonM. McCloskeyE.V. HarveyN.C. JavaidM.K. KanisJ.A. Fragility fractures in Europe: Burden, management and opportunities.Arch. Osteoporos.20201515910.1007/s11657‑020‑0706‑y32306163
    [Google Scholar]
  9. GregsonC.L. ArmstrongD.J. BowdenJ. CooperC. EdwardsJ. GittoesN.J.L. HarveyN. KanisJ. LeylandS. LowR. McCloskeyE. MossK. ParkerJ. PaskinsZ. PooleK. ReidD.M. StoneM. ThomsonJ. VineN. CompstonJ. UK clinical guideline for the prevention and treatment of osteoporosis.Arch. Osteoporos.20221715810.1007/s11657‑022‑01061‑535378630
    [Google Scholar]
  10. SerranoS. MariñosoM.L. SorianoJ.C. Rubiés-PratJ. AubiaJ. CollJ. BoschJ. Del RioL. VilaJ. GodayA. NacherM. Bone remodelling in human immunodeficiency virus-1-infected patients. A histomorphometric study.Bone199516218519110.1016/8756‑3282(94)00028‑X7756046
    [Google Scholar]
  11. RamalhoJ. MartinsC.S.W. GalvãoJ. FurukawaL.N. DominguesW.V. OliveiraI.B. dos ReisL.M. PereiraR.M.R. NickolasT.L. YinM.T. EiraM. JorgettiV. MoysesR.M.A. Treatment of human immunodeficiency virus infection with tenofovir disoproxil fumarate containing antiretrovirals maintains low bone formation rate, but increases osteoid volume on bone histomorphometry.J. Bone Miner. Res.20193491574158410.1002/jbmr.375131269294
    [Google Scholar]
  12. MansuetoP. SeiditaA. VitaleG. GangemiS. IariaC. CascioA. Vitamin D deficiency in HIV infection: Not only a bone disorder.BioMed Res. Int.2015201511810.1155/2015/73561526000302
    [Google Scholar]
  13. CeballosM.E. CarvajalC. JaramilloJ. DominguezA. GonzálezG. Vitamin D and bone mineral density in hiv newly diagnosed therapy-naive patients without any secondary causes of osteoporosis.Calcif. Tissue Int.20191041424910.1007/s00223‑018‑0474‑530209528
    [Google Scholar]
  14. HilemanC.O. OvertonE.T. McComseyG.A. Vitamin D and bone loss in HIV.Curr. Opin. HIV AIDS201611327728410.1097/COH.000000000000027226890209
    [Google Scholar]
  15. MascarauR. BertrandF. LabrousseA. GenneroI. PoinclouxR. Maridonneau-PariniI. Raynaud-MessinaB. VérolletC. HIV-1-infected human macrophages, by secreting RANK-L, contribute to enhanced osteoclast recruitment.Int. J. Mol. Sci.2020219315410.3390/ijms2109315432365752
    [Google Scholar]
  16. AydınO.A. KaraosmanogluH.K. KarahasanogluR. TahmazM. NazlıcanO. Prevalence and risk factors of osteopenia/osteoporosis in Turkish HIV/AIDS patients.Braz. J. Infect. Dis.201317670771110.1016/j.bjid.2013.05.00924076108
    [Google Scholar]
  17. AydınÖ. AnkaralıH. ErgenP. Betül BaysalN. ÇağY. The evaluation of risk factors related to reduced bone mineral density in young people living with HIV.Afr. Health Sci.202222446146910.4314/ahs.v22i4.5237092088
    [Google Scholar]
  18. GuptaP. SinghS. MahtoS. SheoranA. GargaU. LalA. JainP. MathewsS. Prevalence and predictors of low bone mineral density in treatment-naive HIV-infected patients and its correlation with CD4 cell counts.Tzu-Chi Med. J.2021331495410.4103/tcmj.tcmj_177_1933505878
    [Google Scholar]
  19. AtencioP. CabelloA. Conesa-BuendíaF.M. Pérez-TanoiraR. Prieto-PérezL. CarrilloI. ÁlvarezB. Arboiro-PinelR. Díaz-CurielM. Herrero-BeaumontG. MedieroA. GórgolasM. Increased risk factors associated with lower BMD in antiretroviral-therapy–naïve HIV-infected adult male.BMC Infect. Dis.202121154210.1186/s12879‑021‑06263‑934107907
    [Google Scholar]
  20. HoyJ.F. GrundB. RoedigerM. SchwartzA.V. ShepherdJ. AvihingsanonA. Badal-FaesenS. de WitS. JacobyS. La RosaA. PujariS. SchechterM. WhiteD. EngenN.W. EnsrudK. AagaardP.D. CarrA. Immediate initiation of antiretroviral therapy for HIV infection accelerates bone loss relative to deferring therapy: Findings from the START bone mineral density substudy, a randomized trial.J. Bone Miner. Res.20173291945195510.1002/jbmr.318328650589
    [Google Scholar]
/content/journals/chr/10.2174/011570162X311238240603042806
Loading
/content/journals/chr/10.2174/011570162X311238240603042806
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test