title: Bone mineral density changes after 2 years of ARV treatment, compared to naive HIV-1-infected patients not on HAART.
abstract: BACKGROUND
  The prevalence of osteopenia and osteoporosis is increased in human immunodeficiency virus (HIV)-infected patients. The pathogenesis of this low bone mineral density (BMD) is multifactorial.
  
  
  METHODS
  We conducted a prospective study over a 2-year period of the BMD in non-treated ARV-naïve HIV-infected-males, in comparison to HIV-infected males commencing a first ARV treatment, and analyzed the evolution of bone turnover markers.
  
  
  RESULTS
  A total of 39 caucasian males (median age 38.6 years) were enrolled, including 10 who started ARV treatment (group 1), and 29 without indications for ARV therapy (group 2). In the latter group, 11 subjects commenced ARV during the study; therefore the remainder of their follow-up was within group 1, which finally consisted of 21 patients. At baseline, 9 patients (19.5%) had osteoporosis at least at 1 site, while 28 (61%) showed osteopenia. Lower BMD was correlated with tobacco use. Lumbar spine and total hip BMD significantly decreased in group 1 patients after 6 months of treatment, then stabilized (2.4% and 4% loss, respectively, at 24 months), while no significant change in BMD was observed in group 2 subjects. At baseline, one patient had an increased CTX (C-terminal cross-linking telopeptide of type 1 collagen) and all BSAP (bone-specific alkaline phosphatase) results were normal. During follow-up, both CTX and BSAP increased in group 1 patients, while they did not change in group 2.
  
  
  CONCLUSIONS
  Osteoporosis and osteopenia are frequent in HIV-infected males. After ARV initiation, BMD decreased, and bone turnover markers increased, even though the BMD remained stable in non-treated patients. These results underline the impact of HIV treatment on BMD and bone metabolism.
authors.affiliation: From the Le Trait d'Union, Hôpitaux Universitaires Strasbourg.
authors.forename: David
authors.initials: D
authors.lastname: Rey
authors.forename: Michele
authors.initials: M
authors.lastname: Treger
authors.forename: Jean
authors.initials: J
authors.lastname: Sibilia
authors.forename: Michele
authors.initials: M
authors.lastname: Priester
authors.forename: Claudine
authors.initials: C
authors.lastname: Bernard-Henry
authors.forename: Christine
authors.initials: C
authors.lastname: Cheneau
authors.forename: Rose-Marie
authors.initials: RM
authors.lastname: Javier
mesh_terms: D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015519:Bone Density; D024042:Collagen Type I / Q000097:blood; D005272:Femur Neck / Q000000981:diagnostic imaging / Q000473:pathology; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy*; D015497:HIV-1; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000097:blood / Q000139:chemically induced* / Q000000981:diagnostic imaging; D010384:Pelvic Bones / Q000000981:diagnostic imaging / Q000473:pathology; D010455:Peptides / Q000097:blood; D011859:Radiography
chemical_list: D019380:Anti-HIV Agents; D024042:Collagen Type I; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D000469:Alkaline Phosphatase
keywords: Bone mineral density; antiretroviral agents; osteoporosis