title: High prevalence of reduced bone mineral density in primary HIV-1-infected men.
abstract: OBJECTIVE
  To assess the bone mineral density (BMD) in a cohort of men with primary HIV-1 infection (PHI).
  
  
  METHODS
  Thirty-three men with PHI had a dual-energy X-ray absorptiometry (DXA) of the lumbar spine, femoral neck and total hip. Osteopenia and osteoporosis were defined according to WHO criteria as T-scores between -1 and -2.5 and -2.5 or less, respectively. The association between clinical and laboratory parameters and BMD was investigated using multivariable linear regression analysis.
  
  
  RESULTS
  Mean age was 38 (SD 9) years and mean body mass index (BMI) 22.7 (SD 3.3) kg/m. Twenty-four men (73%) had a negative or indeterminate Western blot, 32 men (97%) were combination antiretroviral therapy-naive. Mean plasma HIV-1 RNA was 5.0 (SD 1.2) log10 copies/ml. Mean lumbar spine T (-0.8, SD 1.3, P = 0.001) and Z-scores (-0.7, SD 1.3, P = 0.004) and femoral neck T-score (-0.5, SD 0.9, P = 0.003) were significantly lower compared to the reference population. 15/33 men (45%) had osteopenia and 2/33 (6%) osteoporosis. Markers of bone turnover did not differ between patients with or without osteopenia/osteoporosis. Age was negatively associated with femoral neck (beta-coefficient = -0.05, P < 0.001) and total hip T-scores (beta = -0.03, P = 0.04). BMI was associated with lumbar spine (beta = 0.3), femoral neck (beta = 0.2) and total hip (beta = 0.2) T-scores (P < 0.001) and thyroid-stimulating hormone (TSH) with lumbar spine (beta = 0.5, P = 0.045) and femoral neck T-scores (beta = 0.4, P = 0.005). Increased plasma viral load was associated with lower total hip T-scores (beta = -0.2, P = 0.02).
  
  
  CONCLUSIONS
  Reduced BMD was prevalent in PHI men and was associated with increased age, lower BMI and TSH levels, and higher levels of HIV-1 viremia.
authors.affiliation: Academic Medical Center, University of Amsterdam, Department of Internal Medicine, The Netherlands. m.l.grijsen@amc.uva.nl
authors.forename: Marlous L
authors.initials: ML
authors.lastname: Grijsen
authors.forename: Saskia M E
authors.initials: SM
authors.lastname: Vrouenraets
authors.forename: Radjin
authors.initials: R
authors.lastname: Steingrover
authors.forename: Paul
authors.initials: P
authors.lastname: Lips
authors.forename: Peter
authors.initials: P
authors.lastname: Reiss
authors.forename: Ferdinand W N M
authors.initials: FW
authors.lastname: Wit
authors.forename: Jan M
authors.initials: JM
authors.lastname: Prins
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D015992:Body Mass Index; D015519:Bone Density / Q000276:immunology / Q000502:physiology; D005272:Femur Neck / Q000503:physiopathology / Q000821:virology*; D015658:HIV Infections / Q000150:complications / Q000503:physiopathology / Q000821:virology*; D015497:HIV-1 / Q000276:immunology*; D006615:Hip / Q000503:physiopathology / Q000821:virology*; D006801:Humans; D008159:Lumbar Vertebrae / Q000503:physiopathology / Q000821:virology*; D008297:Male; D010024:Osteoporosis / Q000276:immunology / Q000503:physiopathology / Q000821:virology*; D015995:Prevalence; D012307:Risk Factors; D019562:Viral Load