title: Accelerated bone mineral loss in HIV-infected patients receiving potent antiretroviral therapy.
abstract: BACKGROUND
  The use of highly active antiretroviral therapy (HAART) has been associated with multiple metabolic complications whose pathogenesis is poorly understood at the present time.
  
  
  METHODS
  We performed a cross-sectional analysis of whole-body, lumbar spine (L1-L4) and proximal femur bone mineral density in 112 male subjects (HIV-infected patients on HAART that included a protease inhibitor, HIV-infected patients not receiving a protease inhibitor and healthy seronegative adults) using dual energy x-ray absorptiometry.
  
  
  RESULTS
  Men receiving protease inhibitors had a higher incidence of osteopenia and osteoporosis according to World Health Organization definitions: relative risk = 2.19 (95% confidence interval 1.13-4.23) (P = 0.02). Subjects receiving protease inhibitors had greater central: appendicular adipose tissue ratios than the other two groups (P < 0.0001). There was no relationship between the central: appendicular fat ratio and the lumbar spine or proximal femur bone mineral density t- or z- scores, suggesting that osteoporosis and body fat redistribution are independent side effects of HAART.
  
  
  CONCLUSIONS
  Osteopenia and osteoporosis are unique metabolic complications associated with protease inhibitor-containing potent antiretroviral regimens, that appear to be independent of adipose tissue maldistribution.
authors.affiliation: Department of Medicine, Washington University School of Medicine, St. Louis, Missouri 63108, USA. tebas@im.wustl.edu
authors.forename: P
authors.initials: P
authors.lastname: Tebas
authors.forename: W G
authors.initials: WG
authors.lastname: Powderly
authors.forename: S
authors.initials: S
authors.lastname: Claxton
authors.forename: D
authors.initials: D
authors.lastname: Marin
authors.forename: W
authors.initials: W
authors.lastname: Tantisiriwat
authors.forename: S L
authors.initials: SL
authors.lastname: Teitelbaum
authors.forename: K E
authors.initials: KE
authors.lastname: Yarasheski
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000188:drug therapy* / Q000503:physiopathology*; D017320:HIV Protease Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced*
chemical_list: D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors