Bone Density, Microarchitecture, and Tissue Quality After Long-Term Treatment With Tenofovir/Emtricitabine or Abacavir/Lamivudine
| Autor: | Ana Guelar, Marta Trenchs-Rodríguez, Alicia González-Mena, Sabina Herrera, Robert Güerri-Fernández, Adolfo Diez-Perez, Daniel Molina-Morant, Hernando Knobel, Judit Villar-García |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Bone density Anti-HIV Agents Urology 030209 endocrinology & metabolism HIV Infections Emtricitabine Bone tissue Bone remodeling 03 medical and health sciences 0302 clinical medicine Trabecular bone score Absorptiometry Photon Abacavir Bone Density Medicine Humans Pharmacology (medical) 030212 general & internal medicine Tenofovir business.industry Abacavir/Lamivudine Middle Aged Dideoxynucleosides Drug Combinations Infectious Diseases medicine.anatomical_structure Cross-Sectional Studies Lamivudine Spain Female Bone Remodeling business Body mass index medicine.drug |
| Zdroj: | ResearcherID |
| ISSN: | 1944-7884 |
| Popis: | Objectives HIV infection has been associated with reduced bone mineral density (BMD). Antiretroviral therapy (ART) has a deleterious effect on BMD, but its effect on bone fragility is not clear. The objective of this study is to analyze the BMD, microarchitecture, and tissue quality of bone in patients receiving long-term tenofovir- or abacavir-based ART. Design We conducted a cross-sectional study in patients with HIV undergoing tenofovir or abacavir ART for more than 5 years. Methods We measured BMD using dual X-ray absorptiometry ,bone michroarchitecture using trabecular bone score (TBS), and bone tissue quality using microindentation. TBS is a dual X-ray absorptiometry-based software that is more highly correlated with bone fragility than BMD. Microindentation (BMSi) directly assesses bone quality at the tissue level. Results A total of 63 patients were included in this study, with 36 belonging to the TDF-FTC group and 27 to the ABC-3TC group. Patients receiving TDF-FTC treatment showed lower BMD values than those in the ABC-3TC group. We found no differences in TBS or microindentation between the 2 groups. However, after adjusting for sex, age, body mass index, and 25[OH]vitD we found lower BMSi and thus poorer bone properties in the TDF-FTC group than in the ABC-3TC group [beta coefficient -3.594 (confidence interval: 95% -0.12 to -7.61); P = 0.043]. Conclusions Long-term treatment with TDF-FTC leads to impaired bone health, not only in terms of BMD but also in terms of bone quality, another determinant of overall bone strength. To complement BMD-based predictions, these other techniques may also be used to identify patients with excess fracture risk. |
| Databáze: | OpenAIRE |
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