title: Markers of bone turnover are elevated in patients with antiretroviral treatment independent of the substance used.
abstract: OBJECTIVE
  Osteoporosis and bone fractures are correlated to antiretroviral treatment. It is not clear whether some substances comprise greater risks of bone loss than others.
  
  
  METHODS
  We measured pyridinoline, deoxypyridinoline crosslinks, and bone-specific alkaline phosphatase in 113 HIV-positive patients. We compared patients with and without antiretroviral treatment. We then compared patients with versus without tenofovir and patients with protease inhibitor versus nonnucleoside reverse transcriptase inhibitor use.
  
  
  RESULTS
  Bone-specific alkaline phosphatase, pyridinoline, and deoxypyridinoline crosslinks were significantly higher in patients with antiretroviral treatment compared with patients without antiretroviral treatment: 24.5 versus 13.04 pg/L (P < 0.001), 82.73 versus 51.93 nmol/mmol (P < 0.001), and 16.56 versus 9.94 nmol/mmol (P < 0.001), respectively. In contrast, no difference was found between patients with and without tenofovir: 25.38 versus 20.02 pg/l (P = 0.1); 79.85 versus 83.95 nmol/mmol (P = 0.64), and 19.12 versus 14.00 nmol/mmol (P = 0.14), respectively. Comparison between patients with protease inhibitor versus nonnucleoside reverse transcriptase inhibitor yielded no difference either: 23.07 versus 27.18 pg/L (P = 0.24), 92.96 versus 80.73 nmol/mmol (P = 0.36), and 18.22 versus 16.39 nmol/mmol (P = 0.55).
  
  
  CONCLUSIONS
  Markers for bone turnover are higher in treated compared with untreated patients. No difference concerning tenofovir use or protease inhibitor versus nonnucleoside reverse transcriptase inhibitor use could be found.
authors.affiliation: Department of Medicine, Kantonsspital, Olten, Switzerland. jpiso_ol@spital.ktso.ch
authors.forename: Rein Jan
authors.initials: RJ
authors.lastname: Piso
authors.forename: Madeleine
authors.initials: M
authors.lastname: Rothen
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Rothen
authors.forename: Matthias
authors.initials: M
authors.lastname: Stahl
mesh_terms: D000469:Alkaline Phosphatase / Q000032:analysis; D000596:Amino Acids / Q000032:analysis; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D001842:Bone and Bones / Q000503:physiopathology; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D010024:Osteoporosis / Q000139:chemically induced*
chemical_list: D000596:Amino Acids; D019380:Anti-HIV Agents; C015484:pyridinoline; C036020:deoxypyridinoline; D000469:Alkaline Phosphatase