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Bone. 2013 Nov;57(1):62-7. doi: 10.1016/j.bone.2013.07.019. Epub 2013 Jul 25.

Impact of antiretroviral therapy on bone metabolism markers in HIV-seropositive patients.

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  • 1Rodovia Araraquara - Jaú Km 1, Cep: 14801-902, Araraquara, SP, Brazil. Electronic address: erikagmm7@yahoo.com.br.

Abstract

OBJECTIVE:

To evaluate the impact of antiretroviral therapy (ART) on bone and mineral metabolism and to determine the occurrence of osteopenia and/or osteoporosis in HIV-infected patients taking ART or not.

METHODS:

A cross-sectional study was conducted on 50 HIV-seropositive adult men treated with or not treated with ART. Dual energy X-ray absorptiometry (DXA) was performed and biochemical analyses of the following markers were carried out: FSH, LH, testosterone, total calcium, phosphorus (Pi), magnesium (Mg), albumin, 24h calcium, creatinine, urea, parathormone (PTH), insulin-like growth factor 1 (IGF-I), 25 hydroxyvitamin D (25-OH-D), osteocalcin, and urinary deoxypyridinoline (DPD). The participants were divided into two groups according to ART use or not: Group A, 10 treatment-naive subjects; Group B, ART use for >2years, subdivided into: Group B1, 10 subjects treated with protease inhibitors (PIs) and nucleoside/nucleotide analog reverse transcriptase inhibitors (NRTIs) and Group B2, 10 subjects treated with NRTIs and non-nucleoside analog reverse transcriptase inhibitors (NNRTIs); and Group C, subjects treated with ART <2years, subdivided into: Group C1, 10 subjects treated with PIs and NRTIs and Group C2, 10 subjects treated with NRTIs and NNRTIs.

RESULTS:

The values of the bone formation marker, osteocalcin, were normal in all groups, whereas urinary DPD values were increased in all groups. Whole body DXA revealed a higher percentage of osteopenia (80%) in Group B2. Lumbar spine DXA showed osteoporosis in Groups A and B1 (10%) and total femur DXA in Group B2 (10%).

CONCLUSION:

The increased bone reabsorption marker indicated a high reabsorptive activity of bone tissue. These data indicate a greater osteoclastic activity in bone loss in HIV-infected patients on ART.

© 2013 Elsevier Inc. All rights reserved.

KEYWORDS:

ART; Bone metabolism; HIV; Osteopenia; Osteoporosis

PMID:
23891908
[PubMed - indexed for MEDLINE]
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