Incidence of osteoporosis and osteopenia in men with HIV+ and a history of Kaposi sarcoma

Abstract

Background: Low bone mineral density (BMD) is a common complication of chronic HIV infection, reported between 30%-67% for osteopenia, and between 15%-30% for osteoporosis. Kaposi Sarcoma (KS) is an angioproliferative disease, mediated by cytokines which contributes to inflammation. The objective was to assess the prevalence of BMD in a cohort of HIV+ men with a history of KS.Methods: A retrospective study was performed from January 2019 to March 2021, in men over the age of 40 years and/or with more than 3 years of antiretroviral drugs. Odds Ratios with 95% Confidence Intervals were calculated. P values of ≤0.05 were considered statistically significant. Results: Eighty-four patients were included; mean age was 45.9 ± 8.8 years, and mean time from HIV diagnosis was 9.7 ± 6.8 years. The median baseline CD4+ was 102 cells (IQR 40, 216), and the median viral load was 143 582 copies/ml (IQR 26 527, 341 500). At the time of Dual X-ray Absorptiometry, the median CD4+ count was 361 cell/mL (IQR 225, 518) and the HIV-viral load was undetectable in 80 patients (95.2%). Osteoporosis was documented in 23.8% and osteopenia in 53.6%. The analysis comparing main risk factors, including different ARV drugs for low BMD did not show statistical differences. In the multivariate analysis, NNTRI and disseminated KS were found as protective factors for low BMD. Conclusions: The low BMD reported in this cohort may be related to several risk factors, it is advisable to establish preventive measures for BMD loss, regardless of age.