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Reduced bone mineral density among HIV-infected, virologically controlled young men: prevalence and associated

Arnoo Shaiykova1, Armelle Pasquet2, Cécile Goujard1,3

  • 1Inserm, CESP, U1018, Paris-Sud University, Le Kremlin-Bicêtre.

AIDS (London, England)
|September 21, 2018
PubMed

Insights

Reduced bone mineral density (BMD) is common in young men with HIV despite viral control. Lower BMI, decreased estradiol, and lower lean mass are associated with reduced BMD, while longer combination antiretroviral therapy (cART) duration shows a protective effect.

Area of Science:

  • Endocrinology
  • Infectious Diseases
  • Bone Metabolism

Background:

  • Reduced bone mineral density (BMD) is a significant comorbidity in people living with HIV (PLHIV).
  • Understanding BMD status in virologically controlled PLHIV is crucial for managing long-term health.
  • Younger PLHIV men on combination antiretroviral therapy (cART) represent a population where BMD changes may not be fully characterized.

Purpose of the Study:

  • To determine the prevalence of reduced BMD in young, virologically controlled men with HIV.
  • To identify factors associated with reduced BMD in this population.
  • To evaluate the impact of cART duration on BMD.

Main Methods:

  • A bicentric cross-sectional study involving men under 50 years old with HIV-RNA <50 copies/ml on cART.
  • BMD measurements of the lumbar spine and hip using dual-energy X-ray absorptiometry (DXA).
  • Statistical analyses including linear and polytomous logistic regression to identify associated factors.

Main Results:

  • Nearly half (48.3%) of the 230 participants had reduced BMD (osteopenia or osteoporosis).
  • Lower Body Mass Index (BMI), decreased estradiol levels, and lower lean mass were significantly associated with reduced BMD.
  • Longer duration of cART, especially over 3 years, demonstrated a protective effect on BMD.

Conclusions:

  • A high prevalence of reduced BMD exists in young men with HIV, even with effective viral suppression.
  • Factors such as BMI, estradiol, and lean mass play a role in BMD reduction.
  • Current recommendations for BMD screening may need to be extended to PLHIV under 50 with stable viral control for over three years on cART.
Abstract

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