Decreased bone mineral density in HIV-infected patients is independent of antiretroviral therapy.
OBJECTIVE
To describe the alterations in the bone metabolism of HIV-seropositive patients and evaluate the effects of antiretroviral therapies.


METHODS
Cross-sectional analytical study.


METHODS
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.


RESULTS
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).


CONCLUSIONS
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.
Bruera
Dario
D
Endocrinology Department, Hospital Nacional de Clínicas, Medical Science School, National University of Cordoba, Cordoba, Argentina. dariob@satlink.com
Luna
Norma
N
David
Daniel O
DO
Bergoglio
Liliana M
LM
Zamudio
Javier
J
D015502:Absorptiometry, Photon; D000328:Adult; D000886:Anthropometry; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015519:Bone Density / Q000187:drug effects*; D001851:Bone Diseases, Metabolic / Q000139:chemically induced / Q000821:virology*; D003430:Cross-Sectional Studies; D005260:Female; D005272:Femur Neck / Q000503:physiopathology; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced / Q000821:virology; D013997:Time Factors
D019380:Anti-HIV Agents