Evaluation of bone alterations in the jaws of HIV-infected menopausal women

Abstract

The advent of highly active antiretroviral therapy (HAART) has caused a reduction in mortality, thus contributing to an increase in the number of women with HIV/AIDS who reach the climacteric period, experience decline in ovarian function, and develop complications of viral infection and HAART, which can accelerate bone loss. The aim of this study was to detect possible alterations in the jaws of HIV-infected women by panoramic radiography. The study comprised a total of 120 women above 40 years of age who were divided into the following two groups: women who are HIV positive (Group I) and women with no known HIV infection (Group II). Measurement of the following three radiomorphometric indexes was performed by panoramic radiography: Mental Index (MI), Panoramic Mandibular Index (PMI) and Antegonial Depth (AD). A total of 70% of women in the control group and 50% of women in the HIV group were in the postmenopausal period, and the average values of both MI (p = 0.0054) and AD (p < 0.0001) for this period were lower in the HIV group than in the control group. For patients who were in the premenopausal period, the average AD was lower in the HIV group than in the control group (p = 0.0003). Despite the difference in the average age between groups, greater bone resorption in the mandible was found in the group of HIV-positive women.

Perspectives on menopause and women with HIV

“… 9 , 23 , 122 , 127 , 128 , 131 , 134 , 143 – 154 However, there is evidence that HIV infection itself, independent of its association with these other factors, contributes to bone loss ( Table 4 ). 120 , 122 , 129 , 132 , 133 , 141 , 142 , 144 , 147 , 148 , 155 , 156 A meta-analysis has shown that HIV is associated with a 6.4-fold increased risk of osteopenia/low BMD and a threefold increased risk of osteoporosis. 129 In a cross-sectional study of 120 women over the age of 40 years, those with HIV who were postmenopausal had a lower mental index and antegonial depth on panoramic jaw X-ray examination when compared to those without HIV, while premenopausal HIV-positive women only had lower antegonial depth than HIV-negative women.…”

“… 129 In a cross-sectional study of 120 women over the age of 40 years, those with HIV who were postmenopausal had a lower mental index and antegonial depth on panoramic jaw X-ray examination when compared to those without HIV, while premenopausal HIV-positive women only had lower antegonial depth than HIV-negative women. 156 Yin et al have performed several studies demonstrating lower BMD in women with HIV ( Table 4 ). In a cross-sectional study of HIV-positive, postmenopausal women, mean BMD in the lumbar spine and total hip were significantly lower when compared to historical matched controls.…”

Hormone replacement therapy affects mandibular bone architecture in postmenopausal women: a fractal dimension assessment

“…Panoramic radiographs are regularly requested as a complementary diagnostic examination by dentists and, sometimes, important manifestations of systemic diseases can be found in the gnathic bones [15][16][17][18][19]. Among these, low bone mineral density and morphological changes in trabecular bone reinforce the use of panoramic radiograph together with some clinical parameters to identify patients with osteoporosis [1,20,21].…”

Comorbidities associated with HIV and antiretroviral therapy (clinical sciences): a workshop report

“…For example, both HIV and ART may disturb the osteoclast-osteoblast equilibrium that, in sum, favors the destructive forces of osteoclast activity (Barkhordarian et al, 2011;Ofotokun and Weitzmann, 2011). A recent, singular report found that mandibular BMD in menopausal HIV+ women may be reduced in comparison to older HIV-negative women (Caputo et al, 2013). While low BMD (osteopenia) of the hip and spine in HIV+ adults has been studied extensively (Compston, 2014;Cotter and Mallon, 2014;Erlandson et al, 2014), orofacial bones have not been studied in the same detail.…”