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

Abstract

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.

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

“…These results are similar to those reported in a study performed in 199 HIV + patients in Uganda; 50% of the sample were males, among whom 2% had low BMD in the left hip, compared with 18% in the spine [18]. In 2018-2019, a study carried out at our hospital, which included 48 women with HIV + and a history of cancer, osteoporosis in the lumbar spine was documented in 47.9% and in the femoral neck in 12.5%compared with healthy women in whom osteoporosis was documented in 14.6% in spine and 0% in femoral neck [19].…”