title: Stable bone mineral density over 6 years in HIV-infected men treated with highly active antiretroviral therapy (HAART).
abstract: OBJECTIVE
  Most longitudinal studies of bone mineral density (BMD) in HIV-infected cohorts have been of short duration, typically 1-2 years. Some studies, especially of cohorts treated with highly active antiretroviral therapy (HAART), report short-term stable or increasing BMD, but other studies, often in cohorts initiating HAART, report short-term losses in BMD. We assessed BMD changes over the medium term in HIV-infected men already established on HAART at baseline.
  
  
  METHODS
  Six-year, prospective, longitudinal study.
  
  
  METHODS
  Forty-four HIV-infected men treated with HAART and 37 uninfected, healthy controls.
  
  
  METHODS
  Participants had measurements of BMD at baseline, 2 and 6 years.
  
  
  RESULTS
  In the HIV-infected men at baseline, the mean age was 49 years, the mean duration of infection was 8 years, and the mean duration of HAART was 50 months. Over 6 years of follow-up, there was a greater increase in lumbar spine BMD (5·3%, 95% CI 3·8-6·5%) in the HIV-infected men compared with controls (0·3%, 95% CI -1·0 to 1·6%), P < 0·001. There was no difference between the groups in the change in BMD over time at the total hip (HIV group: -0·6%, 95% CI -1·7 to 0·4%, controls -1·0%, 95% CI -2·2 to 0%, P = 0·8) or at the total body (HIV group, 0·3%, 95% CI -0·3 to 1·0%; controls, 0·5%, 95% CI -0·2 to 1·1%, P = 0·15). Lean mass increased in the HIV group, but not in the controls.
  
  
  CONCLUSIONS
  There was no evidence of accelerated bone loss over 6 years in middle-aged, HIV-infected men treated with HAART. For such patients, routine monitoring of BMD is not necessary over the short/medium term.
authors: Bone and Joint Research Group, Department of Medicine, University of Auckland, Auckland, New Zealand. m.bolland@auckland.ac.nz
authors: Mark J
authors: MJ
authors: Bolland
authors: Andrew
authors: A
authors: Grey
authors: Anne M
authors: AM
authors: Horne
authors: Simon E
authors: SE
authors: Briggs
authors: Mark G
authors: MG
authors: Thomas
authors: Rod B
authors: RB
authors: Ellis-Pegler
authors: Greg D
authors: GD
authors: Gamble
authors: Ian R
authors: IR
authors: Reid
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001835:Body Weight / Q000187:drug effects; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D002118:Calcium / Q000627:therapeutic use*; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014807:Vitamin D / Q000627:therapeutic use*
chemical_list: D050071:Bone Density Conservation Agents; D014807:Vitamin D; D002118:Calcium