title: Calcaneal quantitative ultrasound (QUS) and dual X-ray absorptiometry (DXA) bone analysis in adult HIV-positive patients.
abstract: Human immunodeficiency virus (HIV)-infected patients have an increased risk of developing osteopenia or osteoporosis compared with healthy individuals. Our aim was to compare dual X-ray absorptiometry (DXA), the gold standard for measuring bone mineral density (BMD), with bone quantitative ultrasound (QUS), an alternative technique for predicting fractures and screening low BMD, at least in postmenopausal populations. We analyzed DXA and QUS parameters to investigate their accuracy in the diagnosis and prediction of bone alterations in a cohort of 224 HIV-1-positive patients. The speed of sound (SOS), broadband ultrasound attenuation (BUA) and stiffness index (SI) parameters showed a moderate correlation with DXA, especially with total-body BMD (r coefficient of 0.38, 0.4 and 0.42 respectively), particularly in the female subgroup. In addition, multivariate analysis of HIV-positive patients assessed for vertebral fractures indicated that QUS was more effective than DXA at predicting the risk of fracture. QUS can be used as an additional tool for analyzing bone density in HIV-positive patients and its case of use and low cost make it especially suitable for resource-limited settings where DXA is not employed.
authors.affiliation: Department of Experimental, Diagnostic, and Specialty Medicine, University of Bologna, Microbiology Unit, S. Orsola Malpighi Hospital, Bologna, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Clò
authors.affiliation: Department of Pathology and Diagnostics, Microbiology Unit, University of Verona, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Gibellini
authors.affiliation: Infectious Diseases Unit, Department of Medical and Surgical Sciences, Infectious Diseases Unit, S. Orsola Malpighi Hospital, University of Bologna, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Damiano
authors.affiliation: Endocrinology and Metabolism Unit, University-Hospital S. Maria della Misericordia, Udine, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Vescini
authors.affiliation: Department of Life Sciences, University of Trieste, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Ponti
authors.affiliation: Department of Experimental, Diagnostic, and Specialty Medicine, University of Bologna, Microbiology Unit, S. Orsola Malpighi Hospital, Bologna, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Morini
authors.affiliation: Department of Experimental, Diagnostic, and Specialty Medicine, University of Bologna, Microbiology Unit, S. Orsola Malpighi Hospital, Bologna, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Miserocchi
authors.affiliation: Department of Experimental, Diagnostic, and Specialty Medicine, University of Bologna, Microbiology Unit, S. Orsola Malpighi Hospital, Bologna, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Musumeci
authors.affiliation: Infectious Diseases Unit, Department of Medical and Surgical Sciences, Infectious Diseases Unit, S. Orsola Malpighi Hospital, University of Bologna, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Calza
authors.affiliation: Infectious Diseases Unit, Department of Medical and Surgical Sciences, Infectious Diseases Unit, S. Orsola Malpighi Hospital, University of Bologna, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Colangeli
authors.affiliation: Infectious Diseases Unit, Department of Medical and Surgical Sciences, Infectious Diseases Unit, S. Orsola Malpighi Hospital, University of Bologna, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Viale
authors.affiliation: Department of Experimental, Diagnostic, and Specialty Medicine, University of Bologna, Microbiology Unit, S. Orsola Malpighi Hospital, Bologna, Italy.
authors.forename: Maria Carla
authors.initials: MC
authors.lastname: Re
authors.affiliation: Infectious Diseases Unit, Department of Medical and Surgical Sciences, Infectious Diseases Unit, S. Orsola Malpighi Hospital, University of Bologna, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Borderi
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D015519:Bone Density; D002111:Calcaneus / Q000737:chemistry / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014463:Ultrasonography
keywords: Bone; DXA; HIV; QUS