Longitudinal change in bone mineral density among Chinese individuals with HIV after initiation of antiretroviral therapy

Guo, Fengjin; Song, Xiaojing; Li, Y.; Guan, Wenmin; Pan, Wei Ren; Yu, Wei; Li, T.; Hsieh, Evelyn

doi:10.1007/s00198-020-05584-w

Cited by 12 publications

(9 citation statements)

References 42 publications

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“…Morbidity and mortality of non-AIDS-defining diseases (NADs) have become the increasing burden of PLWH with long-term ART (50)(51)(52)(53)(54)(55)(56)(57). Wang et al carried out an evaluation of the burden, risk factors, and prognosis of serious non-AIDS-defining events (NADEs) among ART-naive AIDS patients admitted to a tertiary hospital between 2009 and 2018 in China (58).…”

Section: Burden Of Hiv/aids Morbidity and Mortalitymentioning

confidence: 99%

Research Progress in the Epidemiology of HIV/AIDS in China

He¹

2021

China CDC Weekly

109

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After thirty-two years since the first domestic outbreak of human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome (AIDS) among injection drug users (IDUs) and almost two decades of comprehensive response efforts by the Chinese government, HIV/AIDS remains a major public health problem. The increasing burden of HIV/AIDS and comorbidities, the emergence of new HIV subtypes and/or circulating recombinant forms and drug mutations, the changing transmission networks, and the urgency of immediate antiretroviral therapy initiation upon an HIV diagnosis are increasingly challenging and altogether likely to have significant impact on the HIV epidemic in China. Upon the call for the global AIDS response to end AIDS by 2030, China needs to develop an innovative and pragmatic roadmap to address these challenges. This review is intended to provide a succinct overview of what China has done in efforts to achieve the global goal of ending AIDS by 2030 and the recently proposed "95-95-95-95" target (95% combination prevention, 95% detection, 95% treatment, 95% viral suppression), and to summarize the most recent progresses in the epidemiological research of HIV/AIDS in China with the aim of providing insights on the next generation of HIV control and prevention approaches and to shed light on upgrading the national strategy to end AIDS in this country.

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Section: Burden Of Hiv/aids Morbidity and Mortalitymentioning

confidence: 99%

Research Progress in the Epidemiology of HIV/AIDS in China

He¹

2021

China CDC Weekly

109

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“…decreases in BMD have been reported between baseline and 2 years in PLWH after initiation of TDF-based ART compared to non-TDF-ART [23,24]. The magnitude of bone loss exceeds that seen after menopause, or approaches that observed during treatment with glucocorticoids or aromatase inhibitors, only within 1-2 years following ART initiation (Fig.…”

Section: Bone Mineral Density and Its Changes Over Hiv Infection Time-coursementioning

confidence: 93%

“…This transient acceleration of bone loss has been attributed to immune reconstitution and is associated with increased bone resorption (via up-regulation of the RANKL/OPG pathway), in addition to the specific effects of some drugs on bone metabolism. Greater decreases in BMD have been reported between baseline and 2 years in PLWH after initiation of TDF-based ART compared to non-TDF-ART [ 23 , 24 ]. The magnitude of bone loss exceeds that seen after menopause, or approaches that observed during treatment with glucocorticoids or aromatase inhibitors, only within 1–2 years following ART initiation (Fig.…”

Section: Bone Characteristics In Plwhmentioning

confidence: 99%

Osteoporosis and HIV Infection

Biver

2022

Calcif Tissue Int

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Life expectancy of people living with HIV (PLWH) is now close to that of the HIV-uninfected population. As a result, age-related comorbidities, including osteoporosis, are increasing in PLWH. This narrative review describes the epidemiology of bone fragility in PLWH, changes of bone features over the course of HIV infection and their determinants, as well as the available evidence regarding the management of osteoporosis in PLWH. The risk of fracture is higher and increases about 10 years earlier compared to the general population. The classical risk factors of bone fragility are very widespread and are major determinants of bone health in this population. The majority of bone loss occurs during virus replication and during immune reconstitution at antiretroviral therapies (ART) initiation, which both increase osteoclast activity. Abnormalities in bone formation and mineralization have also been shown in histomorphometric studies in untreated PLWH. Measurement of bone mineral density (BMD) is the first line tool for assessing fracture risk in postmenopausal women, men above 50 years, and other HIV-infected patients with clinical risk factors for osteoporosis. FRAX underestimates fracture probability in PLWH. In case of indication for anti-osteoporotic drug, bisphosphonates remain the reference option. Calcium and vitamin D supplementation should be considered as ART initiation, since it may attenuate bone loss at this stage. Bone-protective ART regimens improve BMD compared to other regimens, but to a lesser extent than bisphosphonate, and without available data on their influence on the incidence of fracture.

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“…This transitory acceleration of bone loss is related to the Immune Reconstitution Inflammatory Syndrome (IRIS), and this relates to enhanced bone resorption (through upregulation of the RANKL/OPG pathway) as well as the effects of some medicines on bone metabolism. Between the baseline and 2-year mark, TDF-based ARVs were associated with greater declines in BMD in PLWHIV compared to non-TDF-based ARVs [ 37 , 38 ]. Only 1–2 years after ARV initiation does the degree of bone loss surpass that found during menopause or approach that observed after therapy with glucocorticoids or aromatase inhibitors.…”

Section: What Is the Impact Of Hiv On Bone Mineral Density?mentioning

confidence: 99%

Bone Health in People Living with HIV/AIDS: An Update of Where We Are and Potential Future Strategies

et al. 2023

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The developments in Human Immunodeficiency Virus (HIV) treatment and in the care of people living with HIV (PLWHIV) and Acquired Immunodeficiency Syndrome (AIDS) over the last three decades has led to a significant increase in life expectancy, on par with HIV-negative individuals. Aside from the fact that bone fractures tend to occur 10 years earlier than in HIV-negative individuals, HIV is, per se, an independent risk factor for bone fractures. A few available antiretroviral therapies (ARVs) are also linked with osteoporosis, particularly those involving tenofovir disoproxil fumarate (TDF). HIV and hepatitis C (HCV) coinfection is associated with a greater risk of osteoporosis and fracture than HIV monoinfection. Both the Fracture Risk Assessment Tool (FRAX) and measurement of bone mineral density (BMD) via a DEXA scan are routinely used in the assessment of fracture risk in individuals living with HIV, as bone loss is thought to start between the ages of 40 and 50 years old. The main treatment for established osteoporosis involves bisphosphonates. Supplementation with calcium and vitamin D is part of clinical practice of most HIV centers globally. Further research is needed to assess (i) the cut-off age for assessment of osteoporosis, (ii) the utility of anti-osteoporotic agents in PLWHIV and (iii) how concomitant viral infections and COVID-19 in PLWHIV can increase risk of osteoporosis.

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Longitudinal change in bone mineral density among Chinese individuals with HIV after initiation of antiretroviral therapy

Cited by 12 publications

References 42 publications

Research Progress in the Epidemiology of HIV/AIDS in China

Research Progress in the Epidemiology of HIV/AIDS in China

Osteoporosis and HIV Infection

Bone Health in People Living with HIV/AIDS: An Update of Where We Are and Potential Future Strategies

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