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Bone mineral density in HIV infection

Abstract number: R2478

Puerto J.L., Asencio C., Andrey J.L., Escobar M.A., Bernal J.A., Romero S.P., Garcia-Egido A.A., Abu Y.A., Fernandez F.J., Gomez F.

Background: Anti-HIV therapy is associated with an increased prevalence of osteopenia and osteoporosis. Nevertheless, the relationship between the duration of anti-HIV therapy and bone mineral density (BMD) is not established.

Objective: To determine the relationship, if any, between the duration of anti-HIV therapy and bone mineral density.

Methods: Prospective study of BMD in 108 HIV-infected patients, compared with 239 HIV-uninfected controls, from January 2002 to December 2006 at a teaching hospital (median follow-up of 3.86 years).

Results: A total of 108 HIV-infected patients were studied, 76 men (age: 38±11 years, CD4: 351±119/mL) and 32 women (age: 44±16 years, CD4: 368±127/mL), of them 57 initiated HIV therapy in the pre-HAART era (52.8%), 36 (33.3%) and 15 were naive (13.9%). None of the patients received treatment for osteoporosis. Osteoporotic fractures were not observed during follow-up. 66 patients (61%) had osteopenia, and 14 had osteoporosis (13%), with an OR of 5.9 and 3.2, respectively compared to controls. HIV treated patients had a 2.9-fold increased odds of a reduced BMD compared to naive HIV patients. HIV patients treated with PIs had a 4.3-fold increased odds of a reduced BMD compared to patients who did not receive PI treatment, and a 6.8-fold increased odds of a reduced BMD compared to naive HIV patients. Factors associated with a reduced BMD in multivariant analysis were treatment with PIs [RR (95% CI), 2.27 (1.88–2.39), p = 0.03), and time on HIV therapy [RR for <2 years on HIV therapy: 2.33 (1.93–2.68), RR for 2–4 years on HIV therapy: 5.17 (4.52–6.38), and RR for 4 years on HIV therapy: 8.74 (7.06–10.12), p < 0.001 in all cases). Sex, body mass index, CD4 levels or, viral load were not related with the BMD.

Conclusions: HIV infected patients have an increased prevalence of osteopenia (6-fold), that, is associated with the time on anti-viral treatment, and with PIs' therapy.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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