Bone loss and fat loss are closely related in HIV patients on HAART

A number of previous studies have demonstrated that HIV positive individuals on HAART regimens are at increased risk for developing lipoatrophy (fat loss) and bone loss. The aim of the present longitudinal cohort study was to determine whether there is a direct association between the fat mass and bone changes.

The study population consisted of 86 HIV positive patients (73 males, 13 females; 44 PI-experienced, 42 PI-naive) aged 37.3 ±8.6 years. Whole body composition was determined by DEXA; bone mineral content (BMC), fat (FAT), and lean body mass (LEAN) were evaluated for whole body as well as regionally. Two body-composition analyses were obtained for each patient. The second measurement was performed 30 months after the first. The degree of association between the bone and fat mass changes was tested using the Pearson’s correlation coefficient.

Mean BMI on study entry was 24.40 ±3.17 kg/m2, and mean CD4+ count was 362 ±228 cells/mm3. Patients exhibited a significant decrease in their body weight. Weight loss was due exclusively to FAT, while LEAN was not affected.

Fat loss was statistically significant in the arms and legs, but not in the trunk. A significant decrease in the whole body BMC was also evident. Analysis showed a statistically significant positive correlation between the fat and bone mass changes (r = 0.357, p < 0.001).

Conclusions: “In a cohort of HIV-infected individuals receiving antiretroviral treatment, a positive correlation between the bone and fat mass loss was observed. This finding possibly suggests that common pathogenetic mechanisms contribute to lipoatrophy and osteopenia/osteoporosis in HIV-infected patients.”

G Tsekes et al. Bone loss is closely related to fat loss in HIV-infected patients receiving antiretroviral treatment. 10th CROI, 10–14 February 2003, Boston. Abstract 764.

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