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Published on: October 12, 2018
Brief Report: HIV Infection Is Associated With Worse Bone Material Properties, Independently of Bone Mineral Density
Robert Güerri-Fernández1, Daniel Molina, Judit Villar-García
1*Infectious Diseases Department, Hospital del Mar, Hospital del Mar Research Institute (IMIM), Barcelona, Spain; †Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain; ‡Internal Medicine Department, Hospital del Mar, Hospital del Mar Research Institute, Barcelona, Spain; §Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom; and ‖Primary Care, ABS Passeig de Sant Joan, Barcelona, Catalan Institute of Health (ICS), Spain.
Abstract:
Low bone mineral density (BMD) in HIV-infected individuals has been documented in an increasing number of studies. However, it is not clear whether it is the infection itself or the treatment that causes bone impairment. Microindentation measures bone material strength (Bone Material Strength index) directly. We recruited 85 patients, 50 infected with HIV and 35 controls. Median Bone Material Strength index was 84.5 (interquartile range 83-87) in HIV-infected patients and 90 (88.5-93) in controls (P < 0.001). No significant differences in BMD between cases and controls at any of the sites examined (total hip, femoral neck, and lumbar spine). HIV infection is associated with bone damage, independently of BMD.
Insights
HIV infection is linked to bone damage, even when bone mineral density (BMD) appears normal. Microindentation reveals reduced bone material strength in HIV patients, suggesting the infection itself impairs bone health.
Area of Science:
- Orthopedics
- Infectious Diseases
- Bone Biology
Background:
- Low bone mineral density (BMD) is increasingly reported in individuals with HIV.
- The exact cause of bone impairment in HIV patients remains unclear, with ongoing debate about the roles of the infection versus its treatment.
Purpose of the Study:
- To investigate the direct impact of HIV infection on bone material strength, independent of BMD.
- To differentiate the effects of HIV infection from treatment on bone health.
Main Methods:
- Recruited 85 participants: 50 HIV-infected individuals and 35 controls.
- Utilized microindentation to directly measure bone material strength (BMSi).
- Assessed BMD at the total hip, femoral neck, and lumbar spine.
Main Results:
- No significant differences in BMD were found between HIV-infected patients and controls.
- HIV-infected patients exhibited significantly lower median Bone Material Strength index (84.5) compared to controls (90) (P < 0.001).
- This indicates bone damage in HIV infection, irrespective of BMD levels.
Conclusions:
- HIV infection is associated with impaired bone material strength.
- Bone damage in HIV occurs independently of bone mineral density.
- Microindentation is a valuable tool for detecting bone alterations in HIV patients not apparent through BMD scans.
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