Bone mass and mineral metabolism in HIV+ postmenopausal women

Yin, Michael T.; Dobkin, Jay F.; Brudney, Karen; Becker, Carolyn Black; Zadel, Janis L.; Manandhar, Monica; Addesso, Vicki; Shane, Elizabeth

doi:10.1007/s00198-005-1845-0

Cited by 104 publications

(93 citation statements)

References 44 publications

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“…Available data on the role for HIV-related factors in bone loss among HIV-1-infected patients are conflicting [6]. Some studies have suggested that the use of protease inhibitor and of TDF was associated with an increased risk of osteopenia and osteoporosis [1,12,17,24,25] while others failed to confirm this association [18,20,26,27]. In the present study, neither protease inhibitors nor TDF was associated to bone loss with statistical significance, although weak trends of association were observed at several sites for TDF.…”

Section: Discussioncontrasting

confidence: 70%

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Prevalence of Osteoporosis among HIV-1-Infected Men and Women Aged 50 years and Older in Dakar, Senegal: A Cross-Sectional Study

Cournil¹

2015

J AIDS Clin Res

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IntroductionA higher prevalence of low bone mineral density (BMD) and osteoporosis has been described in HIV-1-infected patients compared with HIV-uninfected subjects [1][2][3]. Recent data also suggest that HIV-1-infected people experience higher risks of osteoporosis-related fractures [4,5]. Several factors are involved in the pathogenesis of osteoporosis including traditional factors such as age, gender, low weight, current smoking, reduced physical activity, malnutrition and sex hormone deficiency; but also HIV infection specific risk factors and HIV treatment [6,7].Most studies have been conducted in North America (among both Caucasian and Black American people) and in Europe and bone status is poorly documented in patients living in Sub-Saharan Africa. We have previously reported that quantitative ultrasound (QUS) bone mineral density was lower in HIV-positive patients compared with negative controls from a cross-sectional study conducted in Dakar, Senegal [8]. However, in accordance with International Society Clinical Densitometry (ISCD) 2013 official positions, prevalence of osteoporosis could not be derived from QUS measures [9]. To date, information on osteoporosis among African populations is lacking. Several studies among HIV-positive and negative people reported higher bone mineral density, especially at femoral neck and total hip, as well as lower risk of fracture in African-American compared to Caucasians [10][11][12][13]. If these characteristics are also applied to Africans, it could be expected that HIV-1-infected patients living in sub-Saharan Africa would experience less osteoporosis. Conversely, patients living in resource-limited settings may be more affected by nutritional deficiencies and wasting which are known to be associated with low BMD [6,14].The aim of this cross-sectional study was to estimate the prevalence of osteoporosis based on dual energy X-absorptiometry (DXA) measurements of bone mineral density in Senegalese HIV-1-infected patients living in Dakar and to identify factors associated with osteoporosis in this population. The study focused on men and women aged over 50, for whom diagnosis of osteoporosis from DXA is fully applicable. Methods Study setting and patient populationFrom October, 2012 to February, 2013, a cross-sectional study was conducted at Fann University Hospital in Dakar. All HIV-1-infected AbstractBackground: Published studies reported a high prevalence of osteoporosis among HIV-1-infected subjects, but none of them were conducted in Sub-Saharan Africa. The objective was to estimate prevalence of osteoporosis based on dual energy X-absorptiometry bone mineral density in Senegalese patients above 50 years of age and to identify associated factors.

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Section: Discussioncontrasting

confidence: 70%

“…In a study conducted in the UK, the reported prevalence of osteoporosis in men and women aged over 50 were 17% and 38%, respectively [4]. A cross-sectional study among 31 postmenopausal HIV-positive women in US, reported 42% and 10% of osteoporosis at lumbar spine and total hip, respectively [20].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Osteoporosis among HIV-1-Infected Men and Women Aged 50 years and Older in Dakar, Senegal: A Cross-Sectional Study

Cournil¹

2015

J AIDS Clin Res

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“…In association with these factors, menopausal women experience a period of hormone decline, progressively reducing the effects of estrogen protection on bone metabolism and CVD (8,9). According to Pernerstorfer, metabolic abnormalities resulting from ART are more pronounced in women, suggesting that, after they begin treatment, infected patients lose part of their natural protection against atherosclerosis (9).…”

mentioning

confidence: 99%

“…Before antiretroviral treatment was introduced, few studies had indicated that bone metabolism was affected in HIVpositive patients, although it has recently been confirmed that infected patients present a higher risk of low bone mass and osteoporosis. Despite the fact that that was initially attributed to the use of these medications, it was later confirmed that its origins were due to a series of factors, one of the main ones being metabolic dysfunction of vitamin D (7,8,24).…”

mentioning

confidence: 99%

Vitamin D deficiency in HIV-infected individuals: one more risk factor for bone loss and cardiovascular disease?

Conrado

Miranda-Filho

Bandeira³

2010

Arq Bras Endocrinol Metab

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SummaryThe epidemiological profile of the HIV virus has undergone substantial modifications with advances in antiretroviral therapy. There has been a sharp decline in morbi-mortality levels of HIVinfected patients, which has resulted in higher survival rates. The HIV seropositive population is living longer and more exposed to chronic complications caused by the disease itself and the prolonged use of antiretrovirals. Initially, metabolic alterations were reported, increasing cardiovascular disease risk. Subsequently, damage on bone metabolism was related. SumárioO perfil epidemiológico da infecção pelo vírus HIV vem sofrendo grandes modificações com os avanços na terapia antirretroviral. Houve uma queda expressiva na morbi-mortalidade do paciente infectado pelo HIV e, por conseguinte, aumento da sobrevida. A população soropositiva está envelhecendo e mais exposta às complicações da cronificação da doença e ao uso prolongado dos antirretrovirais. Inicialmente foram descritas alterações metabólicas que contribuem para um aumento no risco de doença cardiovascular. Em seguida, surgiram relatos de danos ao metabolismo ósseo. A deficiência de vitamina D tem atingido proporções epidêmicas envolvendo até mesmo indivíduos saudáveis em regiões tropicais. Dados recentes sugerem sua associação com síndrome metabólica, doenças imunes, diabetes e hipertensão. A doença HIV/Aids e a ação dos antirretrovirais no metabolismo da vitamina D ainda permanecem pouco conhecidas. Em pacientes HIV positivos, fatores ligados ao próprio vírus e ao uso dos antirretrovirais podem estar adicionados às demais causas de hipovitaminose D. Arq Bras Endocrinol Metab. 2010;54(2):118-22

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“…[2][3][4][5][6][7][8][9][10][11][12][13] In a meta-analysis, the prevalence of osteoporosis, defined as a BMD T-score p À 2.5 at the spine and/or hip, was increased threefold and was higher in individuals treated with ART and those exposed to PIs when compared with their respective controls. 14 Most of these studies were conducted in North American, Australian and European populations, and few data are available for black African-infected individuals, who comprise the largest population of HIV-infected people worldwide.…”

Section: Bmd In Hiv-positive Individualsmentioning

confidence: 99%

HIV infection and osteoporosis

Compston

2015

BoneKEy Reports

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In the past two decades, the life expectancy of people living with HIV infection has increased significantly, and osteoporosis has emerged as a significant comorbidity. In addition to traditional risk factors for fracture, specific factors related to HIV infection are also likely to contribute, including antiretroviral therapy. The heterogeneity of the HIV-infected population in terms of age and ethnicity presents many challenges to the prevention and management of bone disease, and further studies are required to establish optimal approaches to risk assessment and treatment.

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Bone mass and mineral metabolism in HIV+ postmenopausal women

Cited by 104 publications

References 44 publications

Prevalence of Osteoporosis among HIV-1-Infected Men and Women Aged 50 years and Older in Dakar, Senegal: A Cross-Sectional Study

Prevalence of Osteoporosis among HIV-1-Infected Men and Women Aged 50 years and Older in Dakar, Senegal: A Cross-Sectional Study

Vitamin D deficiency in HIV-infected individuals: one more risk factor for bone loss and cardiovascular disease?

HIV infection and osteoporosis

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