Chronic Viral Hepatitis Is Associated With Low Bone Mineral Density in HIV-Infected Patients, ANRS CO 3 Aquitaine Cohort

Lawson-Ayayi, S.; Cazanave, Charles; Kpozéhouen, Alphonse; Barthe, Nicole; Mehsen, Nadia; Hessamfar, Mojgan; Dupon, M.; Dabis, François; Néau, Didier

doi:10.1097/qai.0b013e3182845d88

Cited by 11 publications

(20 citation statements)

References 28 publications

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“…No association between liver disease severity and BMD at any site was reported in co-infected patients by ElMaouche et al [15], despite the high histological evidence of cirrhosis (26%). Liver cirrhosis, assessed by liver biopsy or non-invasive methods (FibroScan and FibroTest), was also not found to be associated with decreased BMD in co-infected patients by Lawson-Ayayi et al [25]. In our study the extent of liver fibrosis, measured by transient elastography, was an independent predictor of bone loss in HIV/HCV co-infected patients in the femoral neck DXA Z-and T-scores.…”

Section: Discussionsupporting

confidence: 48%

“…The overall 26% prevalence of frank osteoporosis in our HIV-cohort was higher than the percentages reported in a previous meta-analysis and in other European case studies [1,3,24]. In our HIV/HCV co-infected patients osteoporosis prevalence was significantly higher than among HIV mono-infected subjects, in agreement with previous findings [25]. Many divergences persist regarding the prevalence of osteoporosis in HIV/HCV co-infection [14].…”

Section: Discussioncontrasting

confidence: 46%

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Associated Factors and Liver Disease Severity for Decreased Bone Mineral Density in HIV Mono- and HIV/HCV Co-infected Patients

Vecchi¹,

Soresi²,

Giannitrapani³

et al. 2015

J AIDS Clin Res

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Section: Discussionsupporting

confidence: 48%

Section: Discussioncontrasting

confidence: 46%

Associated Factors and Liver Disease Severity for Decreased Bone Mineral Density in HIV Mono- and HIV/HCV Co-infected Patients

Vecchi¹,

Soresi²,

Giannitrapani³

et al. 2015

J AIDS Clin Res

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“…Several cross-sectional studies in CHB-infected patients alone [9, 10] and among non-cirrhotic CHB- and chronic hepatitis C-infected patients [11–14] have demonstrated that persons with CHB have reduced bone mineral density compared to uninfected individuals. A number of factors related to CHB infection have been hypothesized to contribute to low bone mineral density.…”

Section: Introductionmentioning

confidence: 99%

Risk of hip fracture associated with untreated and treated chronic hepatitis B virus infection

Byrne

Newcomb

Carbonari

et al. 2014

Journal of Hepatology

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Background & Aims Chronic hepatitis B (CHB) infection is associated with reduced bone mineral density, but its association with fractures is unknown. Our objectives were to determine whether untreated or treated CHB-infected persons are at increased risk for hip fracture compared to uninfected persons. Methods We conducted a cohort study among 18,796 untreated CHB-infected, 7,777 treated CHB-infected, and 979,751 randomly sampled uninfected persons within the U.S. Medicaid populations of California, Florida, New York, Ohio, and Pennsylvania (1999 – 2007). CHB infection was defined by two CHB diagnoses recorded >6 months apart and was classified as treated if a diagnosis was recorded and antiviral therapy was dispensed. After propensity score matching of CHB-infected and uninfected persons, Cox regression was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) of incident hip fracture in: 1) untreated CHB-infected versus uninfected, and 2) treated CHB-infected versus uninfected patients. Results Untreated CHB-infected patients of black race had a higher rate of hip fracture than uninfected black persons (HR, 2.55 [95% CI, 1.42 – 4.58]). Compared to uninfected persons, relative hazards of hip fracture were increased for untreated white (HR, 1.26 [95% CI, 0.98 – 1.62]) and Hispanic (HR, 1.36 [95% CI, 0.77 – 2.40]) CHB-infected patients, and treated black (HR, 3.09 [95% CI, 0.59 – 16.22) and white (HR, 1.90 [95% CI, 0.81 – 4.47]) CHB-infected patients, but these associations were not statistically significant. Conclusions Among U.S. Medicaid enrollees, untreated CHB-infected patients of black race had a higher risk of hip fracture than uninfected black persons.

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“…We performed tibial pQCT and whole-body DXA in ART-treated HIV/HCV-coinfected women compared with HCV-monoinfected women, ART-treated HIV-monoinfected women, and healthy women without a history of HIV infection or viral hepatitis. Our analyses focused on women because associations between HIV/HCV coinfection and low BMD have been stronger in women than in men [12,14]. We hypothesized that coinfected women would have lower trabecular volumetric BMD and cortical thinning due to endocortical bone loss, a pattern observed in other chronic inflammatory diseases [20][21][22], compared with HCV-or HIV-monoinfected women and those without a history of either infection.…”

mentioning

confidence: 99%

“…Despite the observed decrements in BMD [11][12][13][14] and increased fracture risk among HIV/HCV-coinfected individuals [10], the structural underpinnings and mechanisms for the skeletal fragility in these patients have not been established. Studies of BMD in coinfected patients have relied exclusively on dualenergy x-ray absorptiometry (DXA), a 2-dimensional projection technique that summarizes total trabecular and cortical bone mass within the projected bone area.…”

mentioning

confidence: 99%

Structural Bone Deficits in HIV/HCV-Coinfected, HCV-Monoinfected, and HIV-Monoinfected Women

Re¹,

Lynn²,

Stumm³

et al. 2015

J Infect Dis.

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Background. Coinfection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) is associated with reduced bone mineral density (BMD) and increased fracture rates, particularly in women. The structural underpinnings for skeletal fragility in coinfected women have not been characterized. We used tibial peripheral quantitative computed tomography to evaluate skeletal parameters in women, by HIV/HCV status.Methods. We conducted a cross-sectional study among 50 HIV/HCV-coinfected, 51 HCV-monoinfected, and 50 HIV-monoinfected women. Tibial volumetric BMD and cortical dimensions were determined with peripheral quantitative computed tomography. Race-specific z scores for age were generated using 263 female reference participants without HIV infection or liver disease.Results. Coinfected participants had lower mean z scores for trabecular volumetric BMD (−0.85), cortical volumetric BMD (−0.67), cortical area (−0.61), and cortical thickness (−0.77) than reference participants (all P < .001). The smaller cortical dimensions were due to greater mean z scores for endosteal circumference (+0.67; P < .001) and comparable z scores for periosteal circumference (+0.04; P = .87). Trabecular volumetric BMD was lower in coinfected than in HCV-or HIV-monoinfected participants. HCV-infected women with stage 3-4 liver fibrosis had lower mean z scores for trabecular volumetric BMD, cortical thickness, and total hip BMD those with stage 0-2 fibrosis.Conclusions. Compared with healthy reference patients, HIV/HCV-coinfected women had decreased tibial trabecular volumetric BMD, diminished cortical dimensions, and significant endocortical bone loss.

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Chronic Viral Hepatitis Is Associated With Low Bone Mineral Density in HIV-Infected Patients, ANRS CO 3 Aquitaine Cohort

Abstract: We found a high prevalence of low BMD overall, but chronic viral hepatitis was independently associated with osteoporosis only in female participants. Our data confirm the need of BMD evaluations for patients living with HIV.

Cited by 11 publications

References 28 publications

Associated Factors and Liver Disease Severity for Decreased Bone Mineral Density in HIV Mono- and HIV/HCV Co-infected Patients

Associated Factors and Liver Disease Severity for Decreased Bone Mineral Density in HIV Mono- and HIV/HCV Co-infected Patients

Risk of hip fracture associated with untreated and treated chronic hepatitis B virus infection

Structural Bone Deficits in HIV/HCV-Coinfected, HCV-Monoinfected, and HIV-Monoinfected Women

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