title: Longitudinal evolution of bone mineral density and bone markers in human immunodeficiency virus-infected individuals.
abstract: The underlying mechanisms of several bone disorders in human immunodeficiency virus (HIV)-infected persons and any relation to antiretroviral therapy have yet to be defined. A longitudinal study was conducted to estimate the prevalence of osteopenia or osteoporosis in HIV-infected persons; to assess bone mineralization, metabolism, and histomorphometry over time; and to evaluate predisposing factors. A total of 128 patients enrolled the study, and 93 were observed for 72 weeks. "Classic" risk factors (low body mass index, history of weight loss, steroid use, and smoking) for low bone mineral density (BMD) and duration of HIV infection were strongly associated with osteopenia. There was a weak association between low BMD and receipt of treatment with protease inhibitors; this association disappeared after controlling for the above factors. Markers of bone turnover tended to be elevated in the whole cohort but were not associated with low BMD. BMD increased slightly during follow-up. Traditional risk factors and advanced HIV infection play a more significant pathogenic role in the development of osteopenia and osteoporosis associated with HIV infection than do treatment-associated factors.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63108, USA.
authors.forename: Kristin
authors.initials: K
authors.lastname: Mondy
authors.forename: Kevin
authors.initials: K
authors.lastname: Yarasheski
authors.forename: William G
authors.initials: WG
authors.lastname: Powderly
authors.forename: Michael
authors.initials: M
authors.lastname: Whyte
authors.forename: Sherry
authors.initials: S
authors.lastname: Claxton
authors.forename: Debra
authors.initials: D
authors.lastname: DeMarco
authors.forename: Mary
authors.initials: M
authors.lastname: Hoffmann
authors.forename: Pablo
authors.initials: P
authors.lastname: Tebas
mesh_terms: D000328:Adult; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000453:epidemiology / Q000209:etiology*; D001842:Bone and Bones / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000503:physiopathology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D015431:Weight Loss