title: Low bone mass prevalence, therapy type, and clinical risk factors in an HIV-infected Brazilian population.
abstract: Low bone mineral density (BMD) has been described in human immunodeficiency virus (HIV)-infected patients, but data on associated factors are still unclear, and to our knowledge, no reports are available in Brazil. Our goal was to evaluate BMD in HIV patients attending an outpatient clinic in Vitoria, Brazil. A sectional study was performed in 300 HIV-infected patients to measure BMD by dual-energy X-ray absorptiometry (DXA). Age, gender, anthropometric parameters, nadir and current CD4 cell count, HIV viral load, smoking habit, and current antiretroviral therapy (ART) associations were investigated by multivariable analysis. Based on World Health Organization T-score ranges, low BMD (T-score <-1.0 standard deviation [SD] in postmenopausal women and men aged 50 and older or Z-score <- 2.0 SD in premenopausal women and men below the age of 50) was detected in 54.7% (95% confidence interval: 49.1-60.3%) of the 300 enrolled patients. The observed median age was 46 yr (interquartile range: 39-52), 58% were male, 88.5% were on ART, and 21.4% smoked. The following factors were identified, by multiple logistic modeling, as being independently associated with low BMD: (1) male gender (4.6 [1.28-16.39]), (2) body mass index lower than 25 kg/m(2) (2.9 [1.31-6.49]), (3) menopause (13.4 [2.53-71.12]), and (4) HIV-1 undetectable viral load (7.9 [1.96-32.25]). Conversely, zidovudine (0.2 [0.04-0.85]) and nevirapine (0.1 [0.02-0.38]) use were inversely associated with low BMD. Low BMD was frequently found in our cohort of about 300 Brazilian HIV-infected subjects. This study supports the need for periodic DXA testing in HIV outpatient clinics.
authors: Escola de Ciências da Santa Casa de Vitoria-EMESCAM, Vitória, Espírito Santo, Brazil.
authors: Lauro F S
authors: LF
authors: Pinto Neto
authors: Sergio
authors: S
authors: Ragi-Eis
authors: Nilo F R
authors: NF
authors: Vieira
authors: Moacir
authors: M
authors: Soprani
authors: Mariza B
authors: MB
authors: Neves
authors: Rodrigo
authors: R
authors: Ribeiro-Rodrigues
authors: Angelica E
authors: AE
authors: Miranda
mesh_terms: D015502:Absorptiometry, Photon; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000453:epidemiology*; D001938:Brazil / Q000453:epidemiology; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010024:Osteoporosis / Q000453:epidemiology; D012307:Risk Factors; D012737:Sex Factors; D019562:Viral Load