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Abnormalities in the bone mineral metabolism in HIV-infected patients

A M García Aparicio1, S Muñoz Fernández, J González

  • 1Rheumatology Unit, Hospital Virgen de la Salud, Avenida Barber, 30, Toledo, 45004, Spain. angel_apa@hotmail.com

Clinical Rheumatology
|October 7, 2005
PubMed

Insights

HIV patients on highly active antiretroviral therapy (HAART) often have osteopenia and vitamin D deficiency. Bone mineral metabolism requires monitoring, and supplementation with calcium and vitamin D may be necessary.

Area of Science:

  • Endocrinology
  • Bone Metabolism
  • HIV Medicine

Background:

  • Human Immunodeficiency Virus (HIV) infection is associated with various comorbidities.
  • Bone mineral metabolism disturbances are increasingly recognized in HIV-infected individuals.

Purpose of the Study:

  • To assess bone mineral metabolism in asymptomatic HIV patients on highly active antiretroviral therapy (HAART) with protease inhibitors (PI) compared to treatment-naïve patients.
  • To identify risk factors for bone disorders in this population.

Main Methods:

  • A cohort of 30 asymptomatic HIV-infected males (13 naïve, 17 on PI-containing HAART) underwent nutritional assessment, DEXA scans (lumbar spine, femur), CD4 count, viral load, and bone turnover markers.
  • Vitamin D and parathyroid hormone (PTH) levels were compared to age-matched healthy controls.
  • Statistical analysis was performed using SPSS.

Main Results:

  • Osteopenia prevalence was high (57% overall), with no significant difference between naïve (61.5%) and PI groups (53%).
  • Vitamin D deficiency was prevalent in 86% of patients, with significantly lower serum levels than controls (p=0.04).
  • Testosterone levels showed a significant positive correlation with lumbar spine bone mineral density (p≤0.05).

Conclusions:

  • HIV infection itself may be an independent risk factor for bone disorders.
  • Routine monitoring of bone mineral metabolism and consideration of calcium and vitamin D supplementation are recommended for HIV patients.
Abstract

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