Low bone mineral density, renal dysfunction, and fracture risk in HIV infection: a cross-sectional study

Calmy, Alexandra; Fux, Christoph A; Norris, Richard; Vallier, Nathalie; Delhumeau, Cécile; Samaras, Katherine; Hesse, Karl; Hirschel, Bernard; Cooper, David A; Carr, Andrew (2009). Low bone mineral density, renal dysfunction, and fracture risk in HIV infection: a cross-sectional study. Journal of infectious diseases, 200(11), pp. 1746-54. Cary, N.C.: The University of Chicago Press 10.1086/644785

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BACKGROUND: Reduced bone mineral density (BMD) is common in adults infected with human immunodeficiency virus (HIV). The role of proximal renal tubular dysfunction (PRTD) and alterations in bone metabolism in HIV-related low BMD are incompletely understood. METHODS: We quantified BMD (dual-energy x-ray absorptiometry), blood and urinary markers of bone metabolism and renal function, and risk factors for low BMD (hip or spine T score, -1 or less) in an ambulatory care setting. We determined factors associated with low BMD and calculated 10-year fracture risks using the World Health Organization FRAX equation. RESULTS: We studied 153 adults (98% men; median age, 48 years; median body mass index, 24.5; 67 [44%] were receiving tenofovir, 81 [53%] were receiving a boosted protease inhibitor [PI]). Sixty-five participants (42%) had low BMD, and 11 (7%) had PRTD. PI therapy was associated with low BMD in multivariable analysis (odds ratio, 2.69; 95% confidence interval, 1.09-6.63). Tenofovir use was associated with increased osteoblast and osteoclast activity (P< or = .002). The mean estimated 10-year risks were 1.2% for hip fracture and 5.4% for any major osteoporotic fracture. CONCLUSIONS: In this mostly male population, low BMD was significantly associated with PI therapy. Tenofovir recipients showed evidence of increased bone turnover. Measurement of BMD and estimation of fracture risk may be warranted in treated HIV-infected adults.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

UniBE Contributor:

Fux, Christoph Andreas

ISSN:

0022-1899

Publisher:

The University of Chicago Press

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:14

Last Modified:

02 Nov 2019 19:01

Publisher DOI:

10.1086/644785

PubMed ID:

19874178

Web of Science ID:

000271662100018

BORIS DOI:

10.7892/boris.32441

URI:

https://boris.unibe.ch/id/eprint/32441 (FactScience: 197649)

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