Structural Bone Deficits in HIV/HCV-Coinfected, HCV-Monoinfected, and HIV-Monoinfected Women

Area of Science:

• Bone biology and skeletal health
• Infectious diseases and immunology
• Radiology and imaging

Background:

• Coinfection with HIV and HCV is associated with reduced bone mineral density (BMD) and higher fracture rates in women.
• The specific structural changes contributing to skeletal fragility in coinfected women remain unclear.

Purpose of the Study:

• To characterize the structural underpinnings of skeletal fragility in women coinfected with HIV and HCV.
• To evaluate tibial bone parameters using peripheral quantitative computed tomography (pQCT) in relation to HIV/HCV status.

Main Methods:

• A cross-sectional study involving 50 HIV/HCV-coinfected, 51 HCV-monoinfected, and 50 HIV-monoinfected women.
• Tibial volumetric BMD and cortical dimensions were assessed using pQCT.
• Race-specific z-scores for age were calculated against a reference group of 263 women without HIV or liver disease.

Main Results:

• HIV/HCV-coinfected women exhibited significantly lower mean z-scores for trabecular volumetric BMD, cortical volumetric BMD, cortical area, and cortical thickness compared to reference participants.
• Reduced cortical dimensions were attributed to increased endosteal circumference with stable periosteal circumference.
• Trabecular volumetric BMD was lower in coinfected women compared to those with mono-infections. Advanced liver fibrosis (stage 3-4) in HCV-infected women correlated with lower BMD and cortical thickness.

Conclusions:

• HIV/HCV coinfection in women is associated with decreased tibial trabecular volumetric BMD and diminished cortical dimensions.
• Significant endocortical bone loss contributes to skeletal fragility in coinfected women.
• These structural bone changes provide a basis for the observed increased fracture risk.