Prevalence and predictors of low bone mineral density in treatment-naive HIV-infected patients and its correlation

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Pulin Kumar Gupta1, Sanchit Singh1, Subodh Kumar Mahto1

  • 1Department of Medicine, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India.

Tzu Chi Medical Journal
|January 28, 2021
PubMed

Insights

Bone disease is common in HIV-infected patients, even before treatment. Low bone mineral density, osteoporosis, and osteopenia are prevalent, linked to low Vitamin D and CD4 counts.

Area of Science:

  • Bone Metabolism and HIV Pathogenesis
  • Endocrinology and Infectious Diseases

Background:

  • HIV infection affects multiple organ systems, including skeletal health.
  • Antiretroviral therapy (ART) is linked to bone disease, but data on treatment-naive patients is limited.

Purpose of the Study:

  • To evaluate bone disease prevalence and associated factors in HIV-infected, ART-naive patients.
  • To compare bone mineral density (BMD) between HIV-infected individuals and healthy controls.

Main Methods:

  • Recruited 120 HIV-infected ART-naive patients and 80 healthy controls.
  • Assessed medical history, performed physical examinations, and conducted laboratory investigations.
  • Measured BMD using dual-energy X-ray absorptiometry at lumbar spine, femur, and forearm.

Main Results:

  • Osteoporosis and osteopenia prevalence was 13% and 41% in HIV patients vs. 0% and 17.5% in controls (P < 0.001).
  • HIV patients had ~25% lower mean BMD than controls.
  • 100% of HIV patients had hypovitaminosis-D compared to 65% of controls (P < 0.01).
  • Low BMD correlated significantly with HIV infection, low CD4 counts, low Vitamin D, disease duration, opportunistic infections, and past tuberculosis.

Conclusions:

  • Bone diseases like osteoporosis and osteopenia are highly prevalent in HIV-infected individuals.
  • Low BMD in HIV patients is associated with the virus itself, low CD4 counts, and low Vitamin D levels.
  • These factors are significant predictors of pathological fractures in HIV-infected patients.
Abstract

Keywords:
Bone mineral densityCD4 countsHIV/acquired immunodeficiency syndromeOsteopeniaOsteoporosis

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