Increased risk factors associated with lower BMD in antiretroviral-therapy–naïve HIV-infected adult male

Atencio, Patricia; Cabello, Alfonso; Conesa-Buendía, Francisco Miguel; Pérez‐Tanoira, Ramón; Prieto-Pérez, Laura; Carrillo, Irene; Álvarez, Beatriz; Arboiro-Pinel, Rosa; Díaz-Curiel, Manuel; Herrero‐Beaumont, Gabriel; Mediero, Aránzazu; Górgolas, Miguel

doi:10.1186/s12879-021-06263-9

Cited by 5 publications

(2 citation statements)

References 35 publications

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“…A loss in bone mineral density, increased osteopenia and osteoporosis have been observed in PLWHIV in various recent studies., [16][17][18] A low BMD level, considering the person's chronological age, was found in at least one of the lumbar, total hip and femoral neck regions among 91 patients (40.6%) in this study. Bone demineralization was present in the femoral neck, total hip and lumbar regions in 26 (11.6%), 26 (11.6%) and 64 (28.6%) patients, respectively.…”

Section: Discussionmentioning

confidence: 46%

The evaluation of risk factors related to reduced bone mineral density in young people living with HIV

Aydın¹,

Ankaralı²,

Ergen³

et al. 2022

Afr H. Sci.

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Background: Low bone mineral density (BMD) is one of the comorbidities that develop in people living with HIV (PLWHIV). Objective: This study was conducted to review the frequency and risk factors of reduced BMD according to age in HIV-infected patients in Turkey. Material and Method: This retrospective cohort study included HIV-infected patients aged 18-50. Bone density was analysed using dual-energy X-ray absorptiometry (DXA) according to the Z-score in three different regions including the lumbar, total-hip and femoral-neck. Results: The study included 224 PLWHIV with a mean age of 35.84-7.54, and 59.8% were ART naive. Of the patients, 40.6% had lower BMD than expected at least in one of the three examined regions including the lumbar, total hip and femoral neck. The low BMD ratios were found respectively as 11.6%, 11.6% and 28.6% in the femoral neck, total hip and lumbar regions. According to the logistic regression model, a high body mass index (p=0.003) and HIV-RNA level of ≥100.000IU/ml during the diagnosis in the ART-naive group (p=0.008) were associated with reduced bone demineralization. The low BMD frequency was high in the group that received ART for <24 months (p=0.001). Conclusion: Performing bone demineralization screening in the naive and young patient group, independently from ART status prior to making the diagnosis of HIV is important for organizing the bone health improvement methods. Keywords: HIV infection; bone density; antiretroviral therapy.

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Section: Discussionmentioning

confidence: 46%

The evaluation of risk factors related to reduced bone mineral density in young people living with HIV

Aydın¹,

Ankaralı²,

Ergen³

et al. 2022

Afr H. Sci.

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“…The prevalence of low BMD in this study is comparable to that in other studies that have described a high prevalence of low BMD in CLWH [ 8 , 19 ]. However, a prevalence rate as low as 4–7% has been reported in well-resourced countries [ 20 – 22 ]. Associated inadequate nutrition may have contributed to the higher prevalence of low BMD, given that our study population resides in a resource-limited setting, where balanced diets are not readily available [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Bone mineral density among children living with HIV failing first-line anti-retroviral therapy in Uganda: A sub-study of the CHAPAS-4 trial

Natukunda,

Szubert,

Otike

et al. 2023

PLoS ONE

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Background Children living with perinatally acquired HIV (CLWH) survive into adulthood on antiretroviral therapy (ART). HIV, ART, and malnutrition can all lead to low bone mineral density (BMD). Few studies have described bone health among CLWH in Sub-Saharan Africa. We determined the prevalence and factors associated with low BMD among CLWH switching to second-line ART in the CHAPAS-4 trial (ISRCTN22964075) in Uganda. Methods BMD was determined using dual-energy X-ray Absorptiometry (DXA). BMD Z-scores were adjusted for age, sex, height and race. Demographic characteristics were summarized using median interquartile range (IQR) for continuous variables and proportions for categorical variables. Logistic regression was used to determine the associations between each variable and low BMD. Results A total of 159 children were enrolled (50% male) with median age (IQR) 10 (7–12) years, median duration of first -line ART 5.2(3.3–6.8) years; CD4 count 774 (528–1083) cells/mm3, weight—for–age Z-score -1.36 (-2.19, -0.65) and body mass index Z-score (BMIZ) -1.31 (-2.06, -0.6). Low (Z-score≤ -2) total body less head (TBLH) BMD was observed in 28 (18%) children, 21(13%) had low lumbar spine (LS) BMD, and15 (9%) had both. Low TBLH BMD was associated with increasing age (adjusted odds ratio [aOR] 1.37; 95% CI: 1.13–1.65, p = 0.001), female sex (aOR: 3.8; 95% CL: 1.31–10.81, p = 0.014), low BMI (aOR 0.36:95% CI: 0.21–0.61, p<0.001), and first-line zidovudine exposure (aOR: 3.68; 95% CI: 1.25–10.8, p = 0.018). CD4 count, viral load and first- line ART duration were not associated with TBLH BMD. Low LS BMD was associated with increasing age (aOR 1.42; 95% CI: 1.16–1.74, p = 0.001) and female sex: (aOR 3.41; 95% CI: 1.18–9.8, p = 0.023). Conclusion Nearly 20% CLWH failing first-line ART had low BMD which was associated with female sex, older age, first-line ZDV exposure, and low BMI. Prevention, monitoring, and implications following transition to adult care should be prioritized to identify poor bone health in HIV+adolescents entering adulthood.

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Impact of strength training on bone mineral density in HIV-positive patients

Santos

Paes

et al. 2022

Fisioter. mov.

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Introduction: Highly active antiretroviral therapy (HAART) transformed HIV from a fatal disease to a chronic one, but it has adverse effects, such as the lipodystrophy syndrome, characterized by morphological and metabolic changes, such as reduced bone mineral density (BMD), potentiating morbidities and mortality. Strength training (ST) aims to increase BMD, due to the osteogenic effect. Objective: To verify the impact of strength training on BMD in people with HIV. Methods: This is a quasi-experimental study, which included 40 people with a mean age of 50 ± 6 years, separated into trained group (TG, n = 20) and control group (CG, n = 20), with reduction in BMD, HIV-positive, using HAART and without exercising. BMD was assessed by DEXA in the lumbar spine, femoral neck and distal 1/3 of the radius, before and after 12 weeks, with the GT submitted to 36 ST and the CG without physical training in the DEXA evaluation in the same time interval. Results: TG had a significant increase with great effect on BMD in all segments: lumbar spine (p = 0.001; ES: 1.87), femoral neck (p = 0.003; ES: 2.20) and 1/3 distal of the radius (p = 0.001; ES: 1.81). Meanwhile, CG group showed a significant reduction with great effect on the femoral neck (p = 0.020; ES: 2.56) and 1/3 distal of the radius (p = 0.015; ES: 2.93), while the lumbar spine showed a great effect to reduce BMD (p = 0.293; ES: 1.78). Conclusion: ST can be used as a therapeutic resource to increase BMD in people with HIV, contributing to the advancement in the search for non-drug therapeutic practices.

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Increased risk factors associated with lower BMD in antiretroviral-therapy–naïve HIV-infected adult male

Cited by 5 publications

References 35 publications

The evaluation of risk factors related to reduced bone mineral density in young people living with HIV

The evaluation of risk factors related to reduced bone mineral density in young people living with HIV

Bone mineral density among children living with HIV failing first-line anti-retroviral therapy in Uganda: A sub-study of the CHAPAS-4 trial

Impact of strength training on bone mineral density in HIV-positive patients

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