title: Prevalence of low bone mineral density in men and women infected with human immunodeficiency virus 1 and a proposal for screening strategy.
abstract: We analyzed data collected during screening for eligibility in the ANRS-120 FOSIVIR clinical trial to estimate the prevalence of osteoporosis in patients infected with human immunodeficiency virus 1 (HIV-1), to study its risk factors, and to develop a screening strategy. McNemar test was used to compare the estimated prevalence of osteoporosis, using 3 different definitions. We then derived a screening strategy for HIV-infected men. We analyzed data for 700 men and 192 women. The prevalence of osteoporosis differed markedly according to the definition used. Based on the "T-score ≤ -2.5" definition, 14.9% of men and 1.0% of women had osteoporosis. Factors associated with low bone mineral density comprised not only classical risk factors for osteoporosis such as low body mass index (BMI) or older age but also factors associated with HIV infection such as lower CD4 T-cell nadir in men and AIDS in women, and with antiretroviral treatment such as recent tenofovir therapy. In addition to postmenopausal women, we recommend osteoporosis screening for HIV-infected men older than 60 yr, men younger than 60 yr with BMI < 20 kg/m(2), and men younger than 60 yr with both BMI 20-23 kg/m(2) and a CD4 T-cell nadir ≤ 200/mm(3).
authors: INSERM U943, Paris Cedex, France; UPMC Univ Paris 06, UMR S943, Paris, France. Electronic address: mmary@ccde.chups.jussieu.fr.
authors: Murielle
authors: M
authors: Mary-Krause
authors: Centre de Diagnostic et de Thérapeutique, APHP, Hôtel-Dieu de Paris, Faculté de Médecine Paris Descartes, Paris, France.
authors: Jean-Paul
authors: JP
authors: Viard
authors: INSERM U943, Paris Cedex, France; UPMC Univ Paris 06, UMR S943, Paris, France.
authors: Béatrice
authors: B
authors: Ename-Mkoumazok
authors: Service de Médecine Interne, APHP, Hôpital Avicenne, Paris, France.
authors: Michelle
authors: M
authors: Bentata
authors: Service des Maladies Infectieuses et tropicales, APHP, Hôpital Pitié-Salpêtrière, Paris, France.
authors: Marc-Antoine
authors: MA
authors: Valantin
authors: INSERM U943, Paris Cedex, France; UPMC Univ Paris 06, UMR S943, Paris, France.
authors: Pascale
authors: P
authors: Missy
authors: INSERM U943, Paris Cedex, France; UPMC Univ Paris 06, UMR S943, Paris, France.
authors: Iuliana
authors: I
authors: Darasteanu
authors: Centre d'Evaluation des Maladies Osseuses, Service de Rhumatologie B, Hôpital Cochin, APHP, Université Paris-Descartes, Paris, France.
authors: Christian
authors: C
authors: Roux
authors: Centre d'Evaluation des Maladies Osseuses, Service de Rhumatologie B, Hôpital Cochin, APHP, Université Paris-Descartes, Paris, France.
authors: Sami
authors: S
authors: Kolta
authors: INSERM U943, Paris Cedex, France; UPMC Univ Paris 06, UMR S943, Paris, France; Service des Maladies Infectieuses et tropicales, APHP, Hôpital Pitié-Salpêtrière, Paris, France.
authors: Dominique
authors: D
authors: Costagliola
authors: Service de Rhumatologie, APHP, Hôpital Pitié-Salpêtrière, Paris, France.
authors: Sylvie
authors: S
authors: Rozenberg
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods*; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D015519:Bone Density; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D015497:HIV-1; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors