title: Chronic viral hepatitis is associated with low bone mineral density in HIV-infected patients, ANRS CO 3 Aquitaine Cohort.
abstract: BACKGROUND
  High prevalence rates of low bone mineral density (BMD) have been reported in people living with HIV infection. We aimed to investigate the association of chronic viral hepatitis with low BMD in HIV-infected patients.
  
  
  METHODS
  A hospital-based cohort of HIV-infected patients was screened for hepatitis B and C coinfection. BMD was measured by dual energy x-ray absorptiometry. T-score was used to define bone status according to the World Health Organization's classification; moreover, each observed BMD value was compared with reference to an average person of the same age and gender as a Z-score <-2.0 allow the diagnosis of patients having less bone mass and/or losing bone material more rapidly than expected. A polytomial logistic regression was performed by gender to investigate the association between chronic viral hepatitis and low BMD (osteopenia and osteoporosis) in HIV-infected patients.
  
  
  RESULTS
  A total of 626 patients (166 females of whom 52 postmenopausal) were recruited: 357 HIV monoinfected, and 269 HIV-coinfected with chronic viral hepatitis, among whom 61 with a diagnosis of cirrhosis. Osteopenia was present in 320 patients (51.1%) and osteoporosis in 187 (29.9%). After adjustment, osteoporosis was associated with older age and low body mass index in both genders. The association between chronic viral hepatitis B or C and osteoporosis was found in women only (odds ratio: 19.0; P value: 0.047).
  
  
  CONCLUSIONS
  We found a high prevalence of low BMD overall, but chronic viral hepatitis was independently associated with osteoporosis only in female participants. Our data confirm the need of BMD evaluations for patients living with HIV.
authors.affiliation: *INSERM Unité 897, Université Bordeaux Segalen, Bordeaux, France; †Institut de Santé Publique, Epidémiologie et Développement (ISPED), Université Bordeaux Segalen, Bordeaux, France; ‡COREVIH d'Aquitaine, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France; §Services des Maladies Infectieuses et Médecine Tropicale, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France; ‖Service d'Imagerie Médicale, CHU de Bordeaux, Bordeaux, France; ¶Service de Rhumatologie, CHU de Bordeaux, Bordeaux, France; and #Service de Médecine Interne et de Maladies Infectieuses, Hôpital Saint André, CHU de Bordeaux, Bordeaux, France. **See the Appendix for details.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Lawson-Ayayi
authors.forename: Charles
authors.initials: C
authors.lastname: Cazanave
authors.forename: Alphonse
authors.initials: A
authors.lastname: Kpozehouen
authors.forename: Nicole
authors.initials: N
authors.lastname: Barthe
authors.forename: Nadia
authors.initials: N
authors.lastname: Mehsen
authors.forename: Mojgan
authors.initials: M
authors.lastname: Hessamfar
authors.forename: Michel
authors.initials: M
authors.lastname: Dupon
authors.forename: François
authors.initials: F
authors.lastname: Dabis
authors.forename: Didier
authors.initials: D
authors.lastname: Neau
mesh_terms: D000328:Adult; D015519:Bone Density; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000503:physiopathology*; D006525:Hepatitis, Viral, Human / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged