Bone density and microarchitecture in hepatitis C and HIV-coinfected postmenopausal minority women

Yin, Michael T.; RoyChoudhury, Arindam; Nishiyama, Kyle K.; Lang, Thomas; Shah, Jainil P.; Olender, Susan; Ferris, David C.; Zeana, Cosmina; Sharma, Anjali; Zingman, Barry S.; Bucovsky, Mariana; Colón, Ivelisse; Shane, Elizabeth

doi:10.1007/s00198-017-4354-z

Cited by 2 publications

(1 citation statement)

References 35 publications

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“…Therefore, strict measures are needed to guard against osteoporosis in terms of regular screening after the age of 50 years using a DEXA scan [ 16 , 17 ], as the risk of HCV affecting BMD is more pronounced in postmenopausal women [ 56 ]. Importantly, Bedimo et al showed that even before the onset of cirrhosis, chronic HCV infection is an independent risk factor for osteoporosis and fractures among PLWHIV [ 57 ]. Carlo et al concluded that vitamin D deficiency might influence liver disease progression in HIV/HCV-coinfected patients [ 58 ].…”

Section: Impact Of Hepatitis C On Bonesmentioning

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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Section: Impact Of Hepatitis C On Bonesmentioning

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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Prevalence of and Risk Factors for Low Bone Mineral Density Assessed by Quantitative Computed Tomography in People Living With HIV and Uninfected Controls

Thomsen

Wiegandt

Gelpi

et al. 2020

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: Low bone mineral density (BMD) has been described in people living with HIV (PLWH). We examined the prevalence of low BMD measured by quantitative computed tomography (QCT), a method that allows 3-dimensional volumetric density measures at the thoracic spine, in well-treated PLWH and uninfected controls and assessed risk factors for reduced BMD. Methods: Cross-sectional study including 718 PLWH from the Copenhagen Co-Morbidity in HIV infection (COCOMO) study and 718 uninfected controls matched on age and sex from the Copenhagen General Population Study (CGPS). Trabecular BMD was determined by QCT. Results: Median BMD was 144.2 mg/cm3 in PLWH vs. 146.6 mg/cm3 in controls (P = 0.580). HIV status was not associated with BMD in univariable or multivariable linear analyses. However, a higher prevalence of very low BMD (T-score ≤ −2.5) was found in PLWH (17.2% vs. 11.0% in controls, P = 0.003). In unadjusted analysis, HIV was associated with very low BMD (odds ratio 1.68 [95% confidence interval: 1.24–2.27], P = 0.001), but this association was not significant after adjusting for age, sex, smoking, alcohol, body mass index, physical activity, and ethnicity. Previous AIDS-defining disease was associated with lower BMD, but no other associations with HIV-specific variables were identified. Conclusion: Using QCT, we found a higher prevalence of very low BMD in PLWH than in controls. However, HIV status was not independently associated with BMD indicating that traditional risk factors contribute to the difference in prevalence of very low BMD. Focus on improvement of lifestyle factors, especially in PLWH with previous AIDS-defining disease, may prevent very low BMD in PLWH.

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Bone density and microarchitecture in hepatitis C and HIV-coinfected postmenopausal minority women

Abstract: HIV+/HCV+ postmenopausal women had significantly lower spine aBMD and vBMD. These deficits in vBMD may contribute to bone fragility and excess fractures reported in HIV+/HCV+ women.

Cited by 2 publications

References 35 publications

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

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

Prevalence of and Risk Factors for Low Bone Mineral Density Assessed by Quantitative Computed Tomography in People Living With HIV and Uninfected Controls

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