title: Low bone mass in human immunodeficiency virus-infected climacteric women receiving antiretroviral therapy: prevalence and associated factors.
abstract: OBJECTIVE
  Low bone mineral density (BMD) has been found in human immunodeficiency virus (HIV)-infected patients; however, data on associated factors remain unclear, specifically in middle-aged women. This study aims to evaluate factors associated with low BMD in HIV-positive women.
  
  
  METHODS
  In this cross-sectional study, a questionnaire was administered to 206 HIV-positive women aged 40 to 60 years who were receiving outpatient care. Clinical features, laboratory test results, and BMD were assessed. Yates and Pearson χ(2) tests and Poisson multiple regression analysis were performed.
  
  
  RESULTS
  The median age of women was 47.7 years; 75% had nadir CD4 T-cell counts higher than 200, and 77.8% had viral loads below the detection limit. There was no association between low BMD at the proximal femur and lumbar spine (L1-L4) and risk factors associated with HIV infection and highly active antiretroviral therapy. Poisson multiple regression analysis showed that the only factor associated with low BMD at the proximal femur and lumbar spine was postmenopause status.
  
  
  CONCLUSIONS
  Low BMD is present in more than one third of this population sample, in which most women are using highly active antiretroviral therapy and have a well-controlled disease. The main associated factor is related to estrogen deprivation. The present data support periodic BMD assessments in HIV-infected patients and highlight the need to implement comprehensive menopausal care for these women to prevent bone loss.
authors.affiliation: From the Departments of 1Obstetrics and Gynecology, and 2Infectious Diseases, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
authors.forename: Debora C
authors.initials: DC
authors.lastname: Gomes
authors.forename: Ana L R
authors.initials: AL
authors.lastname: Valadares
authors.forename: Monica J
authors.initials: MJ
authors.lastname: de Moraes
authors.forename: Bianca B
authors.initials: BB
authors.lastname: Lagrutta
authors.forename: Aarão M
authors.initials: AM
authors.lastname: Pinto-Neto
authors.forename: Lúcia
authors.initials: L
authors.lastname: Costa-Paiva
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D015496:CD4-Positive T-Lymphocytes; D003430:Cross-Sectional Studies; D005260:Female; D006679:HIV Seropositivity / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D008875:Middle Aged; D016012:Poisson Distribution; D017698:Postmenopause / Q000502:physiology*; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D019562:Viral Load