Bone mineral density is not reduced in HIV-infected Caucasian men treated with highly active antiretroviral therapy.
OBJECTIVE
Recent studies have reported low bone mineral density (BMD) in patients infected with human immunodeficiency virus (HIV). Frequently these findings have been attributed to treatment with highly active antiretroviral therapy (HAART). We sought to determine whether BMD in HIV-infected men treated with HAART for at least 3 months is different from that in healthy controls, and, if so, what HIV-related factors might explain this finding.


METHODS
Cross-sectional analysis.


METHODS
Fifty-nine HIV-infected Caucasian men treated with HAART, and 118 healthy community-dwelling controls. Each HIV-infected man was age-matched (within 5 years) to two controls.


METHODS
All participants had measurements of BMD and bone-related laboratory parameters.


RESULTS
The mean duration of known HIV infection was 8.5 years, and of treatment with HAART was 52 months. There was no significant difference in mean BMD between groups at the lumbar spine (HIV group: 1.23 g/cm2, controls: 1.25 g/cm2; P = 0.53) or total body (HIV group: 1.18 g/cm2, controls: 1.20 g/cm2; P = 0.09). At the total hip the HIV-infected group had significantly lower BMD than the control group (HIV group: 1.03 g/cm2, controls: 1.09 g/cm2; P = 0.01). The HIV-infected group were, on average, 6.3 kg lighter than the controls. After adjusting for this weight difference, HIV infection was not an independent predictor of BMD at any site (lumbar spine P = 0.79; total hip P = 0.18; total body P = 0.76).


CONCLUSIONS
HIV-infected men treated with HAART are lighter than healthy controls. This weight difference is responsible for a small decrement in hip BMD. Overall, BMD is not significantly reduced in HIV-infected Caucasian men treated with HAART.
Bolland
Mark J
MJ
Department of Medicine, University of Auckland, Auckland, New Zealand. m.bolland@auckland.ac.nz
Grey
Andrew B
AB
Horne
Anne M
AM
Briggs
Simon E
SE
Thomas
Mark G
MG
Ellis-Pegler
Rod B
RB
Woodhouse
Andrew F
AF
Gamble
Greg D
GD
Reid
Ian R
IR
D000704:Analysis of Variance; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D001835:Body Weight; D015519:Bone Density / Q000187:drug effects*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000503:physiopathology*; D006615:Hip; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008297:Male; D044465:White People
D019380:Anti-HIV Agents