Antiretroviral Therapy and Bone Health

Abstract

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.