Only time with HIV infection and not specific antiretroviral therapy is associated with decreased bone mineral density

The aim of this cross-sectional analytical study was to describe the alterations in the bone metabolism of HIV-seropositive patients and evaluate the effects of antiretroviral therapies. Published in the September 5, 2003 issue of AIDS, this cross-sectional analytical study was undertaken by researchers at the Medical Science School of the National University of Cordoba and Rawson Hospital, Cordoba, Argentina.

A total of 142 subjects (113 male, 29 female), aged 20-45 years were divided into four groups: group A, 33 HIV-seropositive antiretroviral-naive patients; group B1, 36 HIV-seropositive patients on antiviral therapy for over one year, without protease inhibitors (PI); group B2, 42 HIV-seropositive patients on combined therapy containing PI for over one year; and group C, 15 healthy, HIV-seronegative subjects.

Bone mineral density (BMD) was determined by dual energy X-ray absorptiometry in total body, lumbar spine and proximal femur; and evaluation of serum osteocalcin, d-pyridinoline, parathyroid hormone (THP), calcium and phosphate, and urine calcium.

BMD was significantly lower in HIV-seropositive patients in comparison with healthy controls, in all sites studied. However, no statistical differences were observed among all groups of HIV-infected patients, independently of the antiretroviral therapy.

There was a significantly higher occurrence of osteopaenia and osteoporosis in HIV-infected patients in comparison with controls (P < 0.0001), with no differences among treatment-naive patients and either of the treatment groups. Bone formation and resorption markers were similar among all studied groups. There was a significant correlation in all bone sites between time of infection and BMD (P < 0.02).

BMD was significantly lower in HIV-seropositive patients in comparison with controls in lumbar spine, proximal femur and total body, without significant differences among treatment-naive patients and either of the treatment groups.

Only time with HIV infection and not specific therapy was associated with BMD decreases.

Bruera D et al. Decreased bone mineral density in HIV-infected patients is independent of antiretroviral therapy. AIDS 17(13): 1917-1923. September 5, 2003.

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