Reduced bone mineral density among HIV-infected patients in Taiwan: prevalence and associated factors.
BACKGROUND
Reduced bone mineral density (BMD) is an emerging threat to the successful long-term management of human immunodeficiency virus (HIV) infection among patients with access to combination antiretroviral therapy (cART). Data on the prevalence and associated factors of reduced BMD in Asian populations remain scarce.


METHODS
From March 2002 to April 2006, a cross-sectional survey was conducted among HIV-infected patients aged ≥ 20 years at the National Taiwan University Hospital. BMD of the lumbar spine was measured with the use of dual-energy X-ray absorptiometry. Osteopenia was defined as a BMD T-score between -1.0 and -2.5, and osteoporosis was defined as a BMD T-score ≤ -2.5. Linear and ordinal logistic regression analyses were performed.


RESULTS
Among 320 patients with a median age of 37.3 years, body mass index (BMI) of 21.4kg/m(2) and 94.4% on cART, osteopenia and osteoporosis were diagnosed in 35.6% and 3.8%, respectively. On multivariate linear analysis, factors associated with reduced BMD were increasing age (p=0.006), longer duration on antiretroviral therapy (p=0.007), and a decreasing BMI (p=0.002). Using ordinal logistic regression, being underweight with a body mass index (BMI)<18.5kg/m(2) was independently associated with reduced BMD (proportional odds ratio, 4.12; 95% confidence interval, 1.93-8.82).


CONCLUSIONS
Reduced BMD was prevalent among HIV-infected Taiwanese adults on cART. Increased age, lower BMI, and exposure to antiretroviral therapy were significantly associated with decrease of BMD.
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan.
Mao-Song
MS
Tsai
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan.
Chien-Ching
CC
Hung
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan.
Wen-Chun
WC
Liu
Department of Medical Imaging and Radiology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan.
Kuan-Lin
KL
Chen
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan.
Mao-Yuan
MY
Chen
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan.
Szu-Min
SM
Hsieh
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan.
Wang-Huei
WH
Sheng
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan.
Hsin-Yun
HY
Sun
Department of Medical Imaging and Radiology, National Taiwan University Hospital and National Taiwan University, College of Medicine, Taipei, Taiwan. Electronic address: ttfshih@ntu.edu.tw.
Tiffany T F
TT
Shih
D015502:Absorptiometry, Photon; D000328:Adult; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D013131:Spine / Q000000981:diagnostic imaging; D013624:Taiwan / Q000453:epidemiology