Long-term trabecular bone score and bone mineral density changes in Chinese antiretroviral-treated HIV-infected individuals

Guan, Wenmin; Pan, Wei Ren; Yu, Wei; Cao, Wei; Lin, Qian; Zhang, Zaizhu; Song, Xiaojing; Li, Yanling; Tian, Jiang; Xu, Ying; Li, Taisheng; Hsieh, Evelyn

doi:10.1007/s11657-021-00890-0

Cited by 6 publications

(5 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a subgroup analysis of the START study [ 40 ], which followed a racially diverse group of 424 men and women, who were on average 32 years old, for approximately 4.5 years after initiation of ART, the authors concluded that significant reductions in TH and LS BMD plateau one year out from ART initiation and subsequently become similar to BMD loss in groups without HIV. Furthermore, another study that looked at BMD among 457 Chinese PWH (mean age 36.1 years, 8.3% women) through 5 years after ART initiation found a stabilization of BMD after the first 3 years of treatment; then, FN and TH BMD remained low at 5 years relative to baseline and only LS BMD at 5 years was similar to baseline [ 41 ]. The multivariable analysis of our smaller dataset and comparison of the BMD between our two groups is consistent with the START study results, but further investigation looking at a larger sample of older women on ART for over 4.5 years may be informative to understand the BMD trends and fracture risk over time for Latin American women on ART.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of and risk factors for vertebral fracture and low bone mineral density among Peruvian women aging with HIV

et al. 2023

Self Cite

View full text Add to dashboard Cite

Summary Osteoporosis and fracture risk among women with HIV in Latin America is understudied. In a sample of Peruvian women with and without HIV, women with HIV had lower femoral neck and total hip BMD and a higher proportion of vertebral fractures. Important treatment gaps were identified across both groups. Purpose Studies have shown that patients with HIV are at increased risk for bone loss and fracture due to a combination of host, viral, and antiretroviral therapy (ART)-related factors. We aimed to explore the prevalence of vertebral fracture (VF) and low bone mineral density (BMD) among women aging with HIV in Peru and identify risk factors for osteoporosis and fracture in this population. Methods We enrolled women living with and without HIV aged ≥40 years between 2019 and 2020. Participants completed a survey and obtained dual X-ray absorptiometry (DXA) test to assess BMD at the lumbar spine (LS), femoral neck (FN), and total hip (TH). A subset of patients also obtained lateral thoracolumbar X-rays. Presence of VF was determined using the Genant semiquantitative method. Regression analyses were used to model associations between key risk factors and BMD. Results 104 women living with HIV and 212 women living without HIV were enrolled with a mean age of 52.4±8.2 and 56.4±8.8 years ( p < 0.001). Among postmenopausal women (257/316, 81.3%), 26.3% of women living with HIV and 25.9% of those without HIV had osteoporosis. Among the 88 women living with HIV and 178 women living without HIV who obtained thoracolumbar X-rays, 12.5% and 6.2%, respectively, had at least one VF. Based on DXA and the FRAX score, 22/104 women living with HIV met criteria for osteoporosis treatment according to national guidelines; however, none were on treatment. Propensity score matching revealed that women living with HIV had 0.032 g/cm 2 lower FN BMD ( p = 0.012) and 0.034 g/cm 2 lower TH BMD ( p = 0.041) compared to women without HIV. Conclusion In this study, women living with HIV on long-standing ART had increased VF prevalence compared to the slightly older group of women without HIV. Age and BMI were independent predictors for BMD at the lumbar spine, hip, and femoral neck among women living with HIV, and there was a treatment gap among women who met criteria for osteoporosis treatment. Larger studies are needed in this region to identify individuals at risk for fracture and to inform prevention guidelines.

show abstract

Section: Discussionmentioning

confidence: 99%

Prevalence of and risk factors for vertebral fracture and low bone mineral density among Peruvian women aging with HIV

et al. 2023

Self Cite

View full text Add to dashboard Cite

show abstract

“…Follow-up indicators include the frequency of HIV clinic visits and free routine follow-up testing. Routine ART monitoring involved frequency of CD4 testing and viral load assay while extra multi-system screening included risk of cardiovascular [ 49 ] and chronic kidney diseases [ 50 ], electrocardiogram (ECG), assessment of bone mineral density [ 20 ], tuberculosis screening, and serological testing for hepatitis B and C viruses and syphilis during the past 12 months. Except for BMD, which was measured in another tertiary hospital, all HIV-related care was carried out in the study hospital.…”

Section: Methodsmentioning

confidence: 99%

“…With lifelong use of ART, the side effects of some of the medicines are also associated with non-HIV-related chronic conditions, including but not limited to alterations in metabolism, liver and renal functions [ 16 ], bone mineral density (BMD) [ 17 ], and neuropsychiatric effects [ 18 ]. Following the recommendation by current international guidelines for HIV treatment and prevention [ 10 – 12 ], continuous and comprehensive care for people living with HIV receiving ART involves a series of services, including regular follow-up visits to monitor their responses, management of HIV advanced diseases, comprehensive multi-system screening and management of coinfections and chronic complications, such as tuberculosis, viral hepatitis, syphilis, cardiovascular diseases, changes of liver and renal function and loss of BMD, which are associated with HIV infection, aging and access to ART [ 3 , 19 , 20 ]. Furthermore, routine assessment and management of mental health conditions, especially depression, are recommended to be integrated into the package of HIV care services for all people living with HIV in non-psychiatric healthcare settings [ 11 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

“…Because of substantial attrition along the HIV care continuum, especially among people who inject drugs, the program faces severe challenges in retaining the increasing number of people living with HIV in care [ 1 ]. Some Chinese researchers focused on the importance of continuity in HIV care and the management of non-AIDS-related chronic complications, such as cardiovascular diseases, chronic kidney diseases, loss of BMD, highlighting the multidisciplinary chronic care needs of people living with HIV on lifelong ART [ 19 , 20 ]. However, there is lack of consensus around comprehensive continuous care and the lack of certain interventions in the national Chinese guidelines.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Measuring the uptake of continuous care among people living with HIV receiving antiretroviral therapy and social determinants of the uptake of continuous care in the southwest of China: a cross-sectional study

et al. 2021

View full text Add to dashboard Cite

Background Continuous care is essential for people living with HIV. This study aimed to measure continuous care uptake and investigate the association between higher uptake of continuous care and behavioral and social factors, including HIV-acquisition risk and socioeconomic characteristics. Methods A hospital-based cross-sectional study was conducted from April to November 2019 in an HIV treatment center of a specialized hospital in Kunming city, China. Fourteen service indicators were used to calculate composite care scores, which were classified into three levels (low, middle, and high), using principal component analysis. The Behavioral Model for Vulnerable Populations was employed to examine predisposing, enabling, and need factors associated with composite care scores among people living with HIV. Results A total of 702 participants living with HIV aged ≥ 18 years (median age: 41.0 years, 69.4% male) who had been on ART for 1–5 years were recruited. Based on ordinal logistic regression modeling, predisposing factors: being employed (adjusted odds ratio (AOR): 1.54, 95% confidence interval (CI): 1.13–2.11), heterosexuals (AOR: 1.58, 95% CI: 1.11–2.25) and men who have sex with men (AOR: 2.05, 95% CI: 1.39–3.02) and enabling factors: Urban Employee Basic Medical Insurance (AOR: 1.90, 95% CI: 1.03–3.54), middle socioeconomic status (SES) (AOR: 1.42, 95% CI: 1.01–2.01), were positively associated with the higher level of continuous care uptake, compared to the unemployed, people who inject drugs, those with no medical insurance and low SES, respectively. Conclusion There were large differences in continuous care uptake among people living with HIV. HIV-acquisition risk categories and socioeconomic factors were significant determinants of uptake of continuous care. Our findings could inform the development of evidence-based strategies that promote equitable healthcare for all people living with HIV.

show abstract

“… 101 Other studies reported lower trabecular bone score in ART-experienced versus ART-naive people with HIV 93 and an association between longer ART duration and lower BMD. 91 …”

Section: Consensus Statementsmentioning

confidence: 99%

Cardiometabolic health in people with HIV: expert consensus review

Batterham,

Bedimo,

Diaz

et al. 2024

Journal of Antimicrobial Chemotherapy

View full text Add to dashboard Cite

Objectives To develop consensus data statements and clinical recommendations to provide guidance for improving cardiometabolic health outcomes in people with HIV based on the knowledge and experience of an international panel of experts. Methods A targeted literature review including 281 conference presentations, peer-reviewed articles, and background references on cardiometabolic health in adults with HIV published between January 2016 and April 2022 was conducted and used to develop draft consensus data statements. Using a modified Delphi method, an international panel of 16 experts convened in workshops and completed surveys to refine consensus data statements and generate clinical recommendations. Results Overall, 10 data statements, five data gaps and 14 clinical recommendations achieved consensus. In the data statements, the panel describes increased risk of cardiometabolic health concerns in people with HIV compared with the general population, known risk factors, and the potential impact of antiretroviral therapy. The panel also identified data gaps to inform future research in people with HIV. Finally, in the clinical recommendations, the panel emphasizes the need for a holistic approach to comprehensive care that includes regular assessment of cardiometabolic health, access to cardiometabolic health services, counselling on potential changes in weight after initiating or switching antiretroviral therapy and encouraging a healthy lifestyle to lower cardiometabolic health risk. Conclusions On the basis of available data and expert consensus, an international panel developed clinical recommendations to address the increased risk of cardiometabolic disorders in people with HIV to ensure appropriate cardiometabolic health management for this population.

show abstract

Long-term trabecular bone score and bone mineral density changes in Chinese antiretroviral-treated HIV-infected individuals

Cited by 6 publications

References 37 publications

Prevalence of and risk factors for vertebral fracture and low bone mineral density among Peruvian women aging with HIV

Prevalence of and risk factors for vertebral fracture and low bone mineral density among Peruvian women aging with HIV

Measuring the uptake of continuous care among people living with HIV receiving antiretroviral therapy and social determinants of the uptake of continuous care in the southwest of China: a cross-sectional study

Cardiometabolic health in people with HIV: expert consensus review

Contact Info

Product

Resources

About