Bone loss in patients with HIV infection.

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Abstract

[Indexed for MEDLINE] 13. AIDS Care. 2020 Aug;32(8):984-993. doi: 10.1080/09540121.2019.1622631. Epub 2019 May 28. Antiretroviral-naïve HIV-infected patients had lower bone formation markers than HIV-uninfected adults. Wattanachanya L(1)(2), Jantrapakde J(3), Avihingsanon A(4)(5), Ramautarsing R(3), Kerr S(4), Trachunthong D(3), Pussadee K(4), Teeratakulpisarn N(3), Jadwattanakul T(6), Chaiwatanarat T(7), Buranasupkajorn P(1)(2), Phanuphak N(3), Sunthornyothin S(1)(2), Phanuphak P(3)(4); TNT 003 study team(1). Author information: (1)Division of Endocrinology and Metabolism, Department of Medicine, and Hormonal and Metabolic Disorders Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. (2)Excellence Center for Diabetes, Hormone, and Metabolism, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. (3)Thai Red Cross AIDS Research Centre, Bangkok, Thailand. (4)The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Centre, Bangkok, Thailand. (5)Tuberculosis Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. (6)Queen Savang Vadhana Memorial Hospital, Chonburi, Thailand. (7)Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. There are limited studies regarding bone health among people living with HIV (PLHIV) in Asia. We compared bone mineral density (BMD), serum 25-hydroxyvitamin D (25(OH)D) status and bone turnover markers (serum procollagen type1 N-terminal propeptide (P1NP), osteocalcin (OC) and C-terminal cross-linking telopeptide of type1 collagen) among 302 antiretroviral therapy (ART) naive PLHIV compared to 269 HIV-uninfected controls from Thailand. People aged ≥30 years, with and without HIV infection (free of diabetes, hypertension, and active opportunistic infection) were enrolled. BMD at the lumbar spine, total hip, and femoral neck were measured using Hologic DXA at baseline and at 5 years. We analyzed BMD, serum 25(OH)D levels, and bone turnover markers at the patients' baseline visit. PLHIV were 1.5 years younger and had lower BMI. PLHIV had higher mean serum 25(OH)D level and similar BMD to the controls. Interestingly, PLHIV had significantly lower bone formation (serum P1NP and OC), particularly those with low CD4 count. Only a few participants had low bone mass. ARV naïve middle-aged PLHIV did not have lower BMD or lower vitamin D levels compared to the controls. However, PLHIV had lower bone formation markers, particularly those with low CD4 count. This finding supports the benefit of early ART. DOI: 10.1080/09540121.2019.1622631