Long-term changes in bone mineral density after switching to a protease inhibitor monotherapy in HIV-infected subject.
Although some clinical trials have studied the impact of treatments on bone mineral density (BMD), scarce data are available about the impact of protease inhibitor (PI) monotherapies on BMD. The aim of this study was to evaluate changes in BMD in patients after one, two, or three years of a PI monotherapy. This study included 46 HIV-infected patients who switched from a conventional triple antiretroviral strategy to a monotherapy with lopinavir/ritonavir (LPV/r) or darunavir/ritonavir (DRV/r) for one (one-year group, n=16), two (two-year group, n=20), and three (three-year group, n=10) years. BMD was assessed by dual-energy X-ray absorptiometry (DXA). The median percentage of change in total femur BMD was 0.20% after one, 0.79% after two, and -0.31% after three years. The change in lumbar spine was -0.08%, -0.14%, and 0.50% % after the same years. No significant differences were found when patients were classified regarding the type of PI and whether or not had previously received PI or tenofovir. However, patients who interrupted tenofovir or those who started with DRV/r had a higher BMD increment. Patients who had taken non-nucleoside reverse transcriptase inhibitors previously decreased BMD when started PIs. Monotherapy treatment with ritonavir-boosted protease inhibitors (both LPV/r and DRV/r) during one, two, or three years leads to the stabilization of BMD in HIV-infected patients with long-term virological suppression. Larger studies are necessary to compare the effect of starting or withdrawing PIs on BMD.
Lluita contra la Sida Foundation, Germans Trias i Pujol University Hospital, Badalona, Spain. Universitat Autònoma de Barcelona, Barcelona, Spain.
Eugènia
E
Negredo
Lluita contra la Sida Foundation, Germans Trias i Pujol University Hospital, Badalona, Spain. Universitat Autònoma de Barcelona, Barcelona, Spain.
Anna
A
Bonjoch
Lluita contra la Sida Foundation, Germans Trias i Pujol University Hospital, Badalona, Spain. Universitat Autònoma de Barcelona, Barcelona, Spain.
Jordi
J
Puig
Lluita contra la Sida Foundation, Germans Trias i Pujol University Hospital, Badalona, Spain. Universitat Autònoma de Barcelona, Barcelona, Spain.
Patricia
P
Echeverría
Lluita contra la Sida Foundation, Germans Trias i Pujol University Hospital, Badalona, Spain. Universitat Autònoma de Barcelona, Barcelona, Spain.
Carla
C
Estany
Lluita contra la Sida Foundation, Germans Trias i Pujol University Hospital, Badalona, Spain. Universitat Autònoma de Barcelona, Barcelona, Spain.
José R
JR
Santos
Lluita contra la Sida Foundation, Germans Trias i Pujol University Hospital, Badalona, Spain. Universitat Autònoma de Barcelona, Barcelona, Spain.
José
J
Moltó
Lluita contra la Sida Foundation, Germans Trias i Pujol University Hospital, Badalona, Spain. Universitat Autònoma de Barcelona, Barcelona, Spain.
Nuria
N
Pérez-Álvarez
Statistics and Operations Research Department, Universitat Politècnica de Catalunya, Barcelona, Spain.
Arelly
A
Ornelas
Lluita contra la Sida Foundation, Germans Trias i Pujol University Hospital, Badalona, Spain. Universitat Autònoma de Barcelona, Barcelona, Spain.
Bonaventura
B
Clotet
D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use; D015519:Bone Density / Q000187:drug effects*; D005260:Female; D005269:Femur / Q000737:chemistry / Q000187:drug effects* / Q000254:growth & development; D015658:HIV Infections / Q000188:drug therapy* / Q000503:physiopathology / Q000821:virology; D017320:HIV Protease Inhibitors / Q000627:therapeutic use*; D015497:HIV-1 / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008137:Longitudinal Studies; D061466:Lopinavir / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D019438:Ritonavir / Q000627:therapeutic use; D013997:Time Factors; D019562:Viral Load / Q000187:drug effects
D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D061466:Lopinavir; D019438:Ritonavir
Bone density; Demineralization; Densitometry; HIV; Protease inhibitor