Prevalence and risk factors of osteopenia/osteoporosis in Turkish HIV/AIDS patients

Aydın, Özlem Altuntaş; Karaosmanoğlu, Hayat Kumbasar; Karahasanoglu, Rıdvan; Tahmaz, Meryem; Nazlican, Özcan

doi:10.1016/j.bjid.2013.05.009

Cited by 27 publications

(26 citation statements)

References 18 publications

(25 reference statements)

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“…Current data showed that half of HIV-infected patients present late in Turkey. In recently diagnosed patient cohorts, mean (or median in some studies) CD4 counts were reported in a range of 236 to 441/mm 3 (Table 4) (19)(20)(21)(22)(23)(24). In the first analysis of late presenters in the country, we noted that late presenters corresponded to 66% of 209 newly diagnosed HIV-positive individuals (13).…”

Section: Discussionmentioning

confidence: 93%

Late presentation among patients with human immunodeficiency virus infection in Turkey

Karaosmanoğlu¹,

Mete²,

Gündüz

et al. 2019

Cent Eur J Public Health

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Objective: Late presentation of the patients with human immunodeficiency virus (HIV) infection is associated with less favourable treatment responses, more accelerated clinical progression, and a higher mortality risk. Although HIV prevalence is low in Turkey, it is steadily increasing and the information about late presentation among HIV-positives is limited. We aimed to analyze the status of late presentation among HIV-positive patients in Turkey. Methods: All newly diagnosed HIV/AIDS patients from 2003 to 2016 were enrolled in this study by five dedicated centres in Istanbul, Turkey. Demographic data, CD4+ counts, and HIV RNA were collected from medical records and were transferred to a HIV database system. Late presentation was defined as presentation for care with a CD4 count < 350 cells/mm 3 or presentation with an AIDS-defining event, regardless of the CD4 cell count. A medical literature search was done for the analysis of late presentation in Turkey. Results: The cohort included 1,673 patients (1,440 males, median age 35 years). Among them, 847 (50.6%) had an early diagnosis, with a CD count of more than 350 cells/mm 3. The remaining 826 were late presenters. Among late presenters, 427 (25.5% of all, 51.7% of late presenters) presented with advanced HIV disease. Late presenters were more elderly and less educated. The gender seemed comparable between groups. Late presentation was more likely among married patients. Early presenters were more likely among homosexuals, those diagnosed in screening studies, and in lower HIV-RNA viral load category. There has been a decreasing trend among late presenters in 2011-2016 when compared to 2003-2011 period. Conclusion: Current data suggest that half of HIV-infected patients present late in Turkey. In our cohort, those presented late were more elderly, less educated, married and had heterosexual intercourse. On admission, late presenters had more HIV-related diseases and were more likely in higher HIV-RNA category. In the cohort, men having sex with men were less likely late presenters. Efforts to reduce the proportion of late presentation are essential for almost every country. The countries should identify the risk factors of late presentation and should improve early diagnosis and presentation for HIV care.

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Section: Discussionmentioning

confidence: 93%

Late presentation among patients with human immunodeficiency virus infection in Turkey

Karaosmanoğlu¹,

Mete²,

Gündüz

et al. 2019

Cent Eur J Public Health

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“…Apart from traditional risk factors such as old age, female and low BMI, direct effect of ART might contribute [5,6]. Moreover, baseline CD4 + T-cell count was significantly associated with bone loss after ART initiation demonstrating pretreatment immunodeficiency had an effect on bone disorders [7].…”

Section: Introductionmentioning

confidence: 99%

Reduced Bone Mineral Density Among ART-Naive Male Patients with HIV in China

et al. 2015

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Authors contributed equally aims: To evaluate the prevalence and associated factors of reduced bone mineral density (BMD) among antiretroviral therapy (ART) naive HIV-infected male patients in China. Methods: We compared BMD between HIV-infected male patients and healthy controls. Risk factors of reduced BMD were studied using multivariable linear regression. Results: Reduced BMD rate of chronic HIV infection patients was higher. HIV infection was independently associated with decreased BMD after adjusting for demographic factors. Older age, lower BMI and men who have sex with men (MSM) were revealed as the risk factors of lower BMD in HIV-infected male patients. conclusion: Reduced BMD rate of HIV-infected patients was high. Policies are needed for prevention and treatment. KeywordsWidespread use of antiretroviral therapy (ART) has declined HIV-related morbidity and mortality dramatically in both resource-rich and resource-poor areas of the world [1,2]. Concomitantly, comorbidities including metabolic bone disorders are now seen commonly in HIV-infected patients [3]. Reduced bone mineral density (BMD) is a kind of systemic bone diseases characterized by low bone mass, bone microstructure damage and prone to fractures, and is prevalent in HIV-infected subjects [4,5]. Low BMD will increase the risk of fractures, diminish the quality of life, as well as increase the economic burden of the patients and society. Understanding the pathogenesis and risk factors of reduced BMD in HIV patients is urgent for proposing targeted approaches to fracture prevention in this high-risk population.Although the pathogenesis underlying this kind of bone loss is not completely understood, decreased BMD in HIV-infected population are most likely of multifactorial origins. Apart from traditional risk factors such as old age, female and low BMI, direct effect of ART might contribute [5,6]. Moreover, baseline CD4 + T-cell count was significantly associated with bone loss after ART initiation demonstrating pretreatment immunodeficiency had an effect on bone disorders [7]. Recently, the effect of HIV itself has been proposed as a contributor [8,9]. The prevalence of reduced BMD in ART-naive HIV-infected patients was higher than that of the healthy people [9,10]. This suggests that HIV infection may influence BMD regardless of ART status. Furthermore, half of a cohort of untreated acute HIV infection (AHI) men had reduced BMD, demonstrating that bone loss may occur very early [11].BMD assessment in HIV patients is sparsely done in resource-limited setting of China. To date, the condition of bone health among ART-naive HIV-infected patients in China has not For reprint orders, please contact: reprints@futuremedicine.com

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“…Se observó una mediana de 5.9 años en tiempo de exposición a medicamentos en los pacientes que reportaron un baja masa ósea en contraposición con una mediana de 3.4 años en tiempo de exposición a ARV en los pacientes con densitometría normal (p=0.0056). La baja densidad mineral ósea ha sido asociada a la duración de la terapia ARV en algunos grupos estudiados 19,20,21 . La mayor frecuencia de baja masa ósea encontrada en el estudio está asociada a los pacientes que reciben Tenofovir/ Emtricitabina como parte del esquema, lo cual está en concordancia con otros estudios 22,23 .…”

Section: Discussionunclassified

Trastornos de la densidad mineral ósea en personas con VIH en tratamiento antirretroviral Pereira- Risaralda-Colombia

Ruiz-Henao¹,

Arenas-Quintero²,

Estrada-Álvarez³

et al. 2017

Infect

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Cómo citar este artículo: G.I. Ruiz-Henao, et al. Trastornos de la densidad mineral ósea en personas con VIH en tratamiento antirretroviral Pereira-RisaraldaColombia. Infectio 2017; 21(4): 208-213 ResumenObjetivo: La osteoporosis es común en las personas con el virus de inmunodeficiencia humana (VIH). La etiología es multifactorial, involucrando factores de riesgo tradicionales, efectos directos de la infección por el VIH y efectos de los medicamentos antiretrovirales (ARV). Las nuevas evidencias sugieren que el aumento de la prevalencia de la osteoporosis en las personas infectadas por el VIH se traduce en un mayor riesgo de fractura que puede conducir al aumento de morbilidad y mortalidad. Materiales y Métodos: Se realizó un estudio descriptivo de corte transversal en 180 pacientes, que permitió conocer los trastornos de baja masa ósea que presentaban los pacientes estudiados que recibían terapia ARV. Para la medición se usó el método DXA (Dual Energy X Ray Absorptiometry) de columna lumbar y cuello femoral y para la clasificación los criterios de la OMS . Resultados: Se evaluaron 180 pacientes, 76,5% fueron hombres, con un promedio de edad de 41± 11,27 años. Resultaron normales 72,6%, Osteopenia 20,6% y osteoporosis en el 6,7%. El análisis multivariado mostró una asociación significativa importante de la Nevirapina frente a la disminución de la masa ósea (OR a 0,10 IC95% 0,01 -0,8). La combinación Tenofovir / Emtricitabina mostró una frecuencia más alta entre pacientes con disminución de la masa ósea (ORa 3.664 IC95% 1.2 -11.0) Conclusiones: Se hace necesario realizar tamizaje DXA a los pacientes que reciben TAR, para realizar un diagnóstico y tratamiento temprano y evitar complicaciones óseas que alteren la calidad de vida de las personas con VIH.Palabras clave: VIH, Terapia Antiretroviral, Densidad Osea. Disorders of bone mineral density in patients with HIV on antiretroviral treatment-Colombia Risaralda Pereira AbstractObjective: Osteoporosis is common in people with human immunodeficiency virus (HIV). The etiology is multifactorial, involving traditional risk factors, direct effects of HIV infection and effects of antiretroviral drugs (ARVs). New evidence suggests that the increased prevalence of osteoporosis in people with HIV results in an increased risk of fracture that can lead to increased morbidity and mortality. Materials and Methods: A descriptive cross-sectional study was undertaken of 180 patients, which allowed us to see the low bone mass disorders in patients of the study who were receiving ARV therapy. Measurements of lumber spine and femoral neck were made using the DXA (Dual Energy X-Ray Absorptiometry) method and for the classification, criteria of the WHO were used. Results: 180 patients were evaluated. 76.5% were men, with an average age of 41 +-11.27 years. 72.6% were normal, 20.6% had osteopenia and 6.7% osteoporosis. The multivariate analysis showed an important significant association of Nevirapine with the decreased bone mass (ORa 0.10 IC95% 0.01 -0.8). The combination of Tenofovir ...

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Prevalence and risk factors of osteopenia/osteoporosis in Turkish HIV/AIDS patients

Abstract: Our results show a very high prevalence of bone mass reduction in Turkish HIV-infected patients. This study supports the importance of both HIV and antiretroviral therapy in low BMD.

Cited by 27 publications

References 18 publications

Late presentation among patients with human immunodeficiency virus infection in Turkey

Late presentation among patients with human immunodeficiency virus infection in Turkey

Reduced Bone Mineral Density Among ART-Naive Male Patients with HIV in China

Trastornos de la densidad mineral ósea en personas con VIH en tratamiento antirretroviral Pereira- Risaralda-Colombia

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