Association between HIV infection and bone mineral density in climacteric women

Gomes, Débora Castro; Valadares, Ana Lúcia Ribeiro; Amaral, Eliana; Ferreira, Néville de Oliveira; Pinto‐Neto, Aarão Mendes; Baccaro, Luiz Francisco

doi:10.1007/s11657-015-0238-z

Cited by 8 publications

(11 citation statements)

References 30 publications

(42 reference statements)

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“…However, studies from Brazil report a much lower prevalence of decreased bone mineral density in patients with HIV infection, i.e. 14.6 % in the lumbar vertebrae and 5.6 % in the femur [17]. …”

Section: Discussionmentioning

confidence: 99%

Prevalence of osteo-renal impairment in the Romanian HIV cohort

et al. 2016

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Background: The Romanian HIV cohort has certain particularities that render it unique in Europe. We have performed a study to evaluate the prevalence of bone and kidney impairment in this particular group of HIVinfected patients. Methods: We performed dual-energy X-ray absorptiometry (DXA) evaluation of the lumbar vertebrae and the femur, as well as laboratory tests including standard serum panels, bone-related markers and urinalysis in patients from the Romanian HIV cohort. Results: The study included 72 patients, of which 46 (58.3 %) were males. The median (IQR) age was 38 (18) years and the median (IQR) time from HIV infection diagnosis was 9 (13) years. Most patients (55.6 %) were non-smokers, but a relatively high proportion (37.5 %) was currently smoking. Only a small percentage of patients (20.8 %) did not present any comorbidities, while 40.3 % had one comorbidity, the most frequent being dyslipidemia (present in 25 patients, 38.5 %). Only 6 patients had a medical history suggestive for renal disease and 3 for bone-related abnormalities. The median (IQR) glomerular filtration rate was 97.5 (33.0) mL/min/1.73sqm. We diagnosed 21 patients (29.6 %) with stage 2 chronic kidney disease and one patient (1.4 %) with stage 3 chronic kidney disease. Proteinuria was present in 9 (12.7 %) patients. The estimated glomerular filtration rate was significantly lower in patients with cardiac comorbidities (p = 0.013). Vitamin D was significantly lower in smokers compared with non-smokers, with a mean value of 15 vs. 21 ng/mL and a moderate effect size (Cohen's d = −0.5) (p = 0.046). Lumbar osteopenia and osteoporosis were diagnosed in 33.3 and 13.7 % of patients, while femoral osteopenia and osteoporosis were diagnosed in 37.3 and 7.8 %, respectively. Lower nadir CD4 cell counts were found in patients with bone-related comorbidities (p = 0.000). Conclusions: We identified a relatively high prevalence of chronic kidney disease in the Romanian HIV cohort, and a fairly low prevalence of osteopenia and osteoporosis, compared with other European countries. In this category of patients smoking should be avoided altogether, as it may be an indirect risk factor for kidney disease (associating cardiac comorbidities) and it may impair bone metabolism by altering serum levels of hydroxy-vitamin D.

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Section: Discussionmentioning

confidence: 99%

Prevalence of osteo-renal impairment in the Romanian HIV cohort

et al. 2016

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“…When compared to the general population, HIV-infected persons are more likely to have low BMD (34, 58, 61, 64, 65). Strikingly, the risk of bone fracture appears to be higher in people living with HIV as well.…”

Section: Vitamin D and Bone In Hivmentioning

confidence: 99%

Vitamin D and bone loss in HIV

Hileman

Overton

McComsey³

2016

Current Opinion in HIV and AIDS

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Purpose of review Bone health has become an increasingly important aspect of the care of HIV-infected patients as bone loss with antiretroviral therapy (ART) initiation is significant and osteopenia and osteoporosis are highly prevalent. Vitamin D is tightly linked to calcium balance and bone health and vitamin D deficiency is common in HIV. This review outlines the epidemiology of vitamin D deficiency in HIV, summarizes our current understanding of the relationship between vitamin D and bone loss in HIV and the impact of vitamin D supplementation in this patient group. Recent findings While data are conflicting as to whether vitamin D deficiency is more prevalent among HIV-infected individuals than in the general population, there are several reasons for why this patient group may be at heightened risk. Studies linking vitamin D deficiency to bone loss in HIV are limited; however, data from randomized clinical trials suggest a benefit of vitamin D supplementation for the prevention of bone loss with ART initiation and for the treatment of bone loss with bisphosphonate therapy. Summary There are too limited data to recommend universal screening of vitamin D status or supplementation to all HIV-infected individuals. However, testing 25-hydroxyvitamin D levels in those at risk for deficiency and treating patients found to be deficient or initiating antiretroviral therapy or bisphosphonate therapy should be considered. Further study on vitamin D supplementation is needed regarding the potential benefit on immune activation and restoration in this patient group.

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“…11 In Brazil, the prevalence of osteoporosis in HIV-infected patients versus without HIV was 14.6% and 4.6% in spine, and 5.6% versus 3.3% in the femoral neck measurements. 5 In this study, the prevalence of osteoporosis was (12.5%) in femoral neck and 47.9% in spine in patients with HIV, compared with non-HIV-infected patients (1% in femoral neck and 15.6% in spine).…”

Section: Discussionmentioning

confidence: 54%

Prevalence of osteoporosis and osteopenia in a cohort of HIV positive women with a history of treated neoplasms

et al. 2021

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Introduction: Higher prevalence of osteopenia and osteoporosis in HIV positive patients compared to non-infected population has been recognized. However, cancer patients have a higher risk of bone loss and fractures that is multifactorial. The aim of the study was to describe the prevalence of osteopenia and osteoporosis in HIV positive women with history of treated cancer. Methods: Between January 2018 and December 2019, women aged >40 years, HIV+ with a history of cancer diagnosis, who attended the AIDS Cancer Clinic at Instituto Nacional de Cancerología, Mexico City, and who had a dual X-ray absorptiometry performed during the study period were included. Two control groups (CG)—HIV negative women with history of cancer (CG1) and non-HIV, non-cancer women (CG2)—were matched by age 1:1. Results: Forty-eight patients in each group were included; the mean age was 51.1 ± 8.1 years. Osteopenia was found in femoral neck in 54.2% (HIV+), 37.5% (CG1), and 27.1% (CG2), p = 0.02; in spine was 35.7%, 47.9%, and 31.2%, respectively, p = 0.442. Osteoporosis in femoral neck was documented in 12.5%, 2.1%, and 0% in HIV+, CG1, and CG2 ( p = 0.03), and in the spine was 47.9%, 16.7%, and 14.6%, respectively ( p = 0.002). Conclusion: HIV patients with a history of treated cancer have a much higher prevalence of osteoporosis when compared with same-aged HIV-uninfected women with and without cancer. It is necessary to monitor Bone Mineral Density periodically, and all patients should be encouraged to make lifestyle changes, such as avoid tobacco and alcohol, and to increase exercising.

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Association between HIV infection and bone mineral density in climacteric women

Cited by 8 publications

References 30 publications

Prevalence of osteo-renal impairment in the Romanian HIV cohort

Prevalence of osteo-renal impairment in the Romanian HIV cohort

Vitamin D and bone loss in HIV

Prevalence of osteoporosis and osteopenia in a cohort of HIV positive women with a history of treated neoplasms

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