Changes in bone turnover markers with HIV seroconversion and ART initiation.

Area of Science:

• Bone metabolism and HIV research
• Endocrinology and immunology
• Osteoporosis and fracture risk

Background:

• Osteoporosis is prevalent in individuals with HIV, increasing fragility fracture risk.
• The precise influence of HIV on bone metabolism remains incompletely understood.
• Antiretroviral therapy (ART) initiation is known to affect bone mineral density and turnover.

Purpose of the Study:

• To investigate the impact of HIV infection and ART on bone metabolism markers.
• To analyze changes in sclerostin, osteocalcin (OC), procollagen type 1 N terminal propeptide (P1NP), C-telopeptide (CTX), and 25-OH vitamin D.
• To assess bone turnover dynamics in relation to HIV seroconversion and ART initiation.

Main Methods:

• Analysis of serum samples from HIV-seroconverted men in the Multicenter AIDS Cohort Study.
• Measurement of 25-OH vitamin D, P1NP, OC, CTX, and sclerostin at pre-HIV infection, pre-ART, and post-ART timepoints.
• Application of mixed-effects models considering timepoint, age, CD4 count, viral suppression, and season.

Main Results:

• HIV seroconversion was associated with decreased osteocalcin (OC) levels.
• ART initiation correlated with reduced sclerostin concentrations.
• No significant changes were observed in P1NP, CTX, or 25-OH vitamin D levels.

Conclusions:

• HIV infection is associated with a decrease in osteocalcin, a key bone formation marker.
• ART initiation leads to a reduction in sclerostin, a negative regulator of bone formation.
• Both HIV infection and its treatment (ART) appear to influence bone metabolism in white men.