Related Experiment Video
Updated: Mar 2, 2026
Exergaming in Older People Living with HIV Improves Balance, Mobility and Ameliorates Some Aspects of Frailty
Published on: October 6, 2016
Osteoporosis and osteopenia are not associated with T-cell activation in older cART-treated HIV-infected patients
M Krikke1, R C W Klomberg, E van der Veer
1Departments of Internal Medicine and Infectious Diseases, University Medical Center, Utrecht, the Netherlands.
Insights
HIV patients on combination antiretroviral therapy (cART) with osteopenia/osteoporosis showed no difference in T-cell activation. However, longer cART duration correlated with bone formation, and certain drug classes may impact bone mineral density (BMD).
Area of Science:
- Immunology
- Endocrinology
- Virology
Background:
- HIV infection is associated with an increased risk of osteopenia and osteoporosis.
- Combination antiretroviral therapy (cART) is standard for HIV management.
- The relationship between T-cell activation, bone turnover, and bone mineral density (BMD) in HIV patients on cART requires further elucidation.
Purpose of the Study:
- To compare T-cell activation and senescence in HIV patients with low BMD versus normal BMD.
- To examine the association between bone turnover markers (CTX, P1NP) and T-cell activation in HIV patients on cART.
- To investigate the potential influence of cART regimens on BMD in HIV-infected individuals.
Main Methods:
- A pilot study involving 16 male HIV patients on cART.
- Measurement of bone turnover markers (CTX, P1NP).
- Assessment of T-cell activation (CD38+ HLA-DR+) and senescence (CD57+) via flow cytometry.
- Analysis of dual-energy X-ray absorptiometry (DXA) scan data for BMD.
Main Results:
- Nine out of 16 patients had osteopenia/osteoporosis.
- No significant differences in T-cell activation or senescence were observed between patients with low BMD and normal BMD.
- A positive correlation was found between longer cART duration and higher bone formation marker (P1NP) levels.
- Osteopenia/osteoporosis prevalence was higher in patients on protease inhibitors (100%) compared to non-nucleoside reverse transcriptase inhibitors (NNRTIs) (30%).
Conclusions:
- T-cell activation does not appear to explain the higher prevalence of osteopenia/osteoporosis in this cohort of HIV patients on cART.
- cART itself may influence BMD, with potential negative effects from protease inhibitors and protective effects from NNRTIs.
- Further research is warranted to confirm these findings and understand the mechanisms involved in cART-associated bone density changes.
Background:
A higher risk of developing osteopenia/ osteoporosis has been seen in HIV-infected patients. We compared HIV-infected patients, all treated with combination antiretroviral therapy (cART), with a low bone mineral density (BMD) (T-score < -1) to those with a normal BMD (T-score > -1), examining the relation with T-cell activation and bone turnover markers (c-terminal telopeptide (CTX) and procollagen type 1 amino-terminal propeptide (P1NP)).
Methods:
In this single visit pilot study, bone turnover markers, T-cell activation (CD38 + HLA - DR +) and senescence (CD57+) of T cells were measured in patients who had previously undergone dual energy X-ray absorptiometry scanning.
Results:
All study participants (n = 16) were male, on cART, with a median age of 61 years (IQR 56-66). Nine patients had osteopenia/osteoporosis. When comparing the patients with osteopenia/osteoporosis with those with a normal BMD, no differences in activation and senescence were found. A relation was seen between higher bone formation (P1NP) and patients who were on cART for longer. The median length of cART use was 5.5 years (IQR 4.5-7.8), with all patients on nucleoside reverse transcriptase inhibitors, 88% on tenofovir, 63% on non-nucleoside reverse transcriptase inhibitors (NNRTIs) and 38% on protease inhibitors. Osteopenia/osteoporosis was seen in 100% of the patients on protease inhibitors versus 30% of those on NNRTIs.
Conclusion:
This study did not find an association between activated T cells and BMD, thus did not explain the higher prevalence of osteopenia/osteoporosis in HIV-infected patients. Interestingly, this small pilot showed that cART might influence BMD, with a possible negative effect for protease inhibitors and a possible protective effect for NNRTIs. These results warrant further investigation.
More Related Videos
05:53Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty
Published on: July 24, 2013
06:00Development of a Human Preclinical Model of Osteoclastogenesis from Peripheral Blood Monocytes Co-cultured with Breast Cancer Cell Lines
Published on: September 13, 2017
Related Concept Videos
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:17Hormones and Bone Tissue
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
01:22T Cell Activation and Clonal Selection
Naive T cells that have not yet encountered an antigen express two primary CD...
01:31Osteoclasts in Bone Remodeling
01:19The Effect of Aging on Tissues