Bone mineral density remains stable in HAART-treated HIV-infected men over 2 years.
OBJECTIVE
Recently we reported that human immunodeficiency virus (HIV)-infected Caucasian men treated with highly active antiretroviral therapy (HAART) have normal weight-adjusted bone mineral density (BMD), in contrast to most other cross-sectional analyses, which have reported low BMD in HIV-infected patients. We have now addressed the question of whether there is accelerated BMD loss over time in HIV-infected men.


METHODS
A 2-year, prospective, longitudinal study.


METHODS
Twenty-three HAART-treated, HIV-infected men and 26 healthy controls.


METHODS
All participants had measurements of BMD and bone-related laboratory parameters at baseline, and a repeat measurement of BMD at 2 years.


RESULTS
In the HIV-infected men the mean age was 47 years, the mean duration of infection was 8.2 years, and the mean duration of HAART was 54 months. Over 2 years of follow-up, BMD increased from baseline in the HIV-infected men by 2.6% at the lumbar spine (P = 0.05 vs. baseline), and remained stable at the total hip (mean change 0.1%, P > 0.99) and total body (mean change 0.6%, P = 0.39). Mean changes in BMD in the control group were 1.4% at the lumbar spine, -0.1% at the total hip, and -0.8% at the total body. The HIV-infected men lost less total body BMD than the control group (P = 0.01). In the HIV-infected men, body weight remained stable over 2 years while fat mass decreased and lean mass tended to increase, whereas in the controls, body weight and fat mass increased while lean mass remained stable.


CONCLUSIONS
Accelerated bone loss does not occur in HIV-infected men treated with HAART. Monitoring of BMD in HIV-infected men may not be necessary.
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
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D001823:Body Composition; D015519:Bone Density / Q000502:physiology*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D015658:HIV Infections / Q000188:drug therapy* / Q000503:physiopathology*; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D019380:Anti-HIV Agents