Bone mineral density changes after 2 years of ARV treatment, compared to naive HIV-1-infected patients not on HAART
Autor: | Jean Sibilia, Christine Cheneau, Claudine Bernard-Henry, Rose-Marie Javier, Michèle Priester, David Rey, Michele Treger |
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Rok vydání: | 2014 |
Předmět: |
musculoskeletal diseases
Microbiology (medical) Adult Male medicine.medical_specialty Tobacco use Anti-HIV Agents Osteoporosis Human immunodeficiency virus (HIV) HIV Infections medicine.disease_cause Collagen Type I Bone remodeling Bone Density Internal medicine medicine Humans Prospective cohort study Pelvic Bones Bone mineral Lumbar Vertebrae General Immunology and Microbiology business.industry Femur Neck virus diseases General Medicine Middle Aged medicine.disease Alkaline Phosphatase Surgery Osteopenia Radiography Infectious Diseases HIV-1 Lumbar spine business Peptides |
Zdroj: | Infectious diseases (London, England). 47(2) |
ISSN: | 2374-4243 |
Popis: | 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.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.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.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. |
Databáze: | OpenAIRE |
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