Low bone mineral density and associated risk factors in HIV-infected patients

Chiţu-Tișu, Cristina-Emilia; Barbu, Ecaterina-Constanţa; Lazăr, Mihai; Ion, Daniela Adriana; Bădărău, Ioana Anca

doi:10.11599/germs.2016.1089

Cited by 20 publications

(23 citation statements)

References 23 publications

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“…A comparable prevalence in reduced BMD (23%) was found by Cardeal et al (2017) among 108 individuals living with HIV in Brazil [23]. However, some studies have reported higher prevalence rates of reduced BMD ranging from 37% to 80% among PLWHIV [18][19][20]35]. A slightly lower prevalence in reduced BMD revealed in this study could be due to the age group of participants.…”

Section: Discussionsupporting

confidence: 80%

“…Higher prevalence rates of up to 85% of low BMD among PLWHIV in low and middle income countries have been reported by a number of studies [18][19][20][21][22]. Apart from ART, factors such as lack of physical activity (PA), lower body mass index (BMI), female sex, older age, nutritional deficiencies of calcium and vitamin D, depression, contraception use, smoking and alcohol use are believed to contribute to high prevalence of low BMD among PLWHIV [22][23][24][25].…”

Section: Introductionmentioning

confidence: 99%

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Reduced bone mineral density among HIV infected patients on anti-retroviral therapy in Blantyre, Malawi: Prevalence and associated factors

2020

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Introduction Use of tenofovir based anti-retroviral therapy (ART) in HIV patients is associated with low bone mineral density (BMD). Low BMD predisposes people living with HIV (PLWHIV) to fractures thereby increasing morbidity and mortality. Since the introduction of tenofovir based ARV regimens in 2011, information on the prevalence of low BMD in PLWHIV and receiving ART is still scarce in Malawi. This study aimed to determine the prevalence and associated factors of low BMD among adults living with HIV and receiving ART in Blantyre, Malawi. Methodology This was a cross sectional study involving 282 HIV-positive adults of whom 102 (36%) were males. The participants aged 18-45 years were recruited from three primary and one tertiary health care facilities. Patients with no other comorbidities or conditions associated with low BMD and on ART >12 months were included. Data on BMD (femoral neck and lumbar spine) were collected using Dual-Energy X-ray Absorptiometry (DEXA). The International Physical Activity Questionnaire (IPAQ) was used to assess the physical activity (PA) levels. Participants' body weight (kg) and height (m) were also measured. Descriptive statistics, Chi-Square test and multivariable logistic regression were used to analyse data. Results Mean age of participants was 37(± 6.4) years, mean duration on ART was 5(± 3.5) years and mean body mass index (BMI) was 23(± 4.5) kg/m 2. Twenty percent (55) had reduced BMD. More males (28%) had reduced BMD than females (14%) (p = 0.04). There was a significant association between lumbar BMD and femoral neck BMD (r = 0.66,p<0.001).

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Reduced bone mineral density among HIV infected patients on anti-retroviral therapy in Blantyre, Malawi: Prevalence and associated factors

2020

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“…Our results are consistent with other reports from South-Eastern Europe [5,6,32]. Chiţu-Tișu and colleagues observed a similar prevalence of reduced BMD (17% osteoporosis and 48% osteopenia) in 60 HIV-infected patients in Romania.…”

Section: Discussionsupporting

confidence: 93%

“…Chiţu-Tișu and colleagues observed a similar prevalence of reduced BMD (17% osteoporosis and 48% osteopenia) in 60 HIV-infected patients in Romania. They noted that patients with more prolonged exposure to non-nucleoside reverse transcriptase inhibitors were at higher risk of low BMD [6]. Another group noted a 47% prevalence of low lumbar BMD in Romanian patients, together with a relatively high prevalence of chronic kidney disease.…”

Section: Discussionmentioning

confidence: 99%

Antiretroviral Therapy and Bone Health

Yancheva¹,

Temelkova

Strashimirov³

et al. 2019

Acta Medica Bulgarica

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Objective: To determine the incidence of osteopenia and osteoporosis in Bulgarian human immunodeficiency virus (HIV)-infected patients. Methods: Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry in 41 Bulgarian HIV-infected patients. Results: Overall, 27% of patients had reduced BMD (7% osteoporosis and 20% osteopenia). There was a significant correlation between low BMD and increasing age and between low BMD and duration of antiretroviral therapy (ART) but no correlation with gender, therapy regimen or serum calcium or phosphate levels. Seventy-one percent had elevated serum cystatin C levels but there was no correlation between BMD and cystatin C levels. Serum calcium, phosphate, cystatin C and creatinine levels and the T- and Z-scores were tested for dependence on duration of therapy. Dependence was found for T- and Z-scores, (p = 0.048 and p = 0.038) but not for calcium, phosphate, cystatin C or creatinine levels. These variables were subsequently tested by means of cross-tabulation tables for correlations between pairs of parameters; no significant correlation was found between any pairs (R > 0.5 for all comparisons). Conclusions: Significant correlations were observed between low BMD and increasing age and longer duration of ART but no relationship was observed with gender or therapy regimen.

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“…In fact, HIV-infected infected subjects have lower BMI than HIV-negative control groups, as described previously 22 . Several reports demonstrated that habit of smoking, and lifestyle, traditional known risk factors for osteoporosis, are also important in this population 23 , 24 .…”

Section: Discussionsupporting

confidence: 76%

Low bone mineral density among HIV-infected patients in Brazil

Chaba

Soares

Pereira

et al. 2017

Rev. Inst. Med. trop. S. Paulo

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Decrease in bone mineral density (BMD) has been a complication among people living with HIV/AIDS. To investigate the prevalence of osteopenia/osteoporosis among HIV-infected people living in São Paulo city, we studied 108 HIV-infected patients (79 men and 29 women). We extracted data from patients’ medical records and BMD was measured by dual-energy X-ray absorptiometry (DXA). Median age of participants was 42 years (interquartile range [IQR] 36-48 years), and the median time since HIV diagnosis was 4.01 years (IQR 2-11 years). Patients had acquired HIV primarily by the sexual route (men who have sex with men 44%, heterosexual 49%). Median age, duration of HIV infection, duration of ART and CD4 nadir were similar for men and women. Plasma viral load was undetectable for 53 patients (49%). Median CD4 T cell count was 399 cells/µL (IQR 247 - 568). Twenty five patients (23%) had LBMD, and there was no statistically significant difference between men and women (<-1). The associated risk factors for LBMD were older age (≥ 50 years old) and smoking with a RR of 3.87 and 2.80, respectively. Thus, despite the lack of statistically significant relationship between the use of ART and LBMD or between duration of ART and LBMD, these factors should be addressed in larger studies.

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Low bone mineral density and associated risk factors in HIV-infected patients

Abstract: At lumbar spine DEXA, male gender was statistically associated with reduced BMD. At the left hip Ward's area, decreased BMD T scores were significantly associated with aging. The reduced BMD was higher in patients receiving PI- or NNRTI-containing regimens.

Cited by 20 publications

References 23 publications

Reduced bone mineral density among HIV infected patients on anti-retroviral therapy in Blantyre, Malawi: Prevalence and associated factors

Reduced bone mineral density among HIV infected patients on anti-retroviral therapy in Blantyre, Malawi: Prevalence and associated factors

Antiretroviral Therapy and Bone Health

Low bone mineral density among HIV-infected patients in Brazil

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