title: Low bone mass in behaviorally HIV-infected young men on antiretroviral therapy: Adolescent Trials Network Study 021B.
abstract: BACKGROUND
  Peak bone mass is achieved in adolescence/early adulthood and is the key determinant of bone mass in adulthood. We evaluated the association of bone mass with human immunodeficiency virus (HIV) infection and antiretroviral therapy (ART) during this critical period among behaviorally HIV-infected young men and seronegative controls.
  
  
  METHODS
  HIV-positive men (N = 199) and HIV-negative controls (N = 53), ages 14-25 years, were studied at 15 Adolescent Trials Network for HIV/AIDS Interventions sites. HIV-positive participants were recruited on the basis of ART status: ART-naive (N = 105) or on a regimen containing a nonnucleoside reverse transcriptase inhibitor (NNRTI; N = 52) or protease inhibitor (PI; N = 42). Bone mineral density (BMD) and content (BMC) and body composition were measured by dual-energy X-ray absorptiometry (DXA). Results were compared across groups by linear modeling. Bone results were adjusted for race, body mass index (BMI), and type of DXA (Hologic/Lunar).
  
  
  RESULTS
  The HIV-positive and HIV-negative groups had comparable median age (21 years) and racial/ethnic distribution. Median times since HIV diagnosis were 1.3, 1.9, and 2.2 years in the ART-naive, NNRTI, and PI groups, respectively (P = .01). Total and regional fat were significantly lower in the ART-naive group compared with seronegative controls. Mean BMD and Z scores were generally lower among HIV-positive participants on ART, particularly in the PI group. Average Z scores for the spine were below zero in all 4 groups, including controls.
  
  
  CONCLUSIONS
  Young men on ART with a relatively recent diagnosis of HIV infection have lower bone mass than controls. Longitudinal studies are required to determine the impact of impaired accrual or actual loss of bone during adolescence on subsequent fracture risk.
authors.affiliation: University of California, San Francisco, USA. kathleen.mulligan@ucsf.edu
authors.forename: Kathleen
authors.initials: K
authors.lastname: Mulligan
authors.forename: D Robert
authors.initials: DR
authors.lastname: Harris
authors.forename: Patricia
authors.initials: P
authors.lastname: Emmanuel
authors.forename: Roger A
authors.initials: RA
authors.lastname: Fielding
authors.forename: Carol
authors.initials: C
authors.lastname: Worrell
authors.forename: Bill G
authors.initials: BG
authors.lastname: Kapogiannis
authors.forename: Dina
authors.initials: D
authors.lastname: Monte
authors.forename: John
authors.initials: J
authors.lastname: Sleasman
authors.forename: Craig M
authors.initials: CM
authors.lastname: Wilson
authors.forename: Grace M
authors.initials: GM
authors.lastname: Aldrovandi
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D044966:Anti-Retroviral Agents / Q000008:administration & dosage*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D001823:Body Composition / Q000502:physiology; D015519:Bone Density; D001846:Bone Development / Q000502:physiology*; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents