Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jan 1:2019:1279318.
doi: 10.1155/2019/1279318. eCollection 2019.

Impact of HIV-1 Infection and Antiretroviral Therapy on Bone Homeostasis and Mineral Density in Vertically Infected Patients

D Donà  1   2 , E Mozzo  1 , D Luise  3 , R Lundin  2 , A Padoan  4 , O Rampon  1 , C Giaquinto  1   2
Affiliations

Impact of HIV-1 Infection and Antiretroviral Therapy on Bone Homeostasis and Mineral Density in Vertically Infected Patients

D Donà et al. J Osteoporos. .

Abstract

Daily assumption of antiretroviral drugs and HIV-related immune activation lead to important side effects, which are particularly evident in vertically infected patients. Bone homeostasis impairment and reduction of bone mineral density (BMD) is one of the most important side effects. Primary aim of this study is to assess the prevalence of bone homeostasis alterations in a group of vertically infected patients; secondary aim is to analyze the relationship between bone homeostasis alterations and anthropometric data, severity of HIV infection, and antiretroviral therapy. We studied 67 patients with vertically transmitted HIV-1 (aged 6-31 years), followed by the Pediatric Infectious Disease Unit of the University Hospital of Padua, Italy. We analyzed bone turnover markers (P1NP and CTx) and we performed lumbar spine and femoral dual energy X-ray absorption densitometry (DXA). Personal and anthropometric data and information on HIV-infection severity and antiretroviral therapy were collected for all patients. We found that BMD values recorded by DXA showed a significant correlation with age, race, BMI, physical activity, and antiretroviral therapy duration. P1NP was increased in 43% of patients, while CTX in 61% of them. P1NP alteration was related to age, race, BMI, physical activity, therapy duration, and ever use of protease inhibitors and nucleotide reverse transcriptase inhibitors. CTX alteration was found to be correlated only with age. In conclusion, our study confirms that a wide percentage of HIV vertically infected patients show reduced BMD and impaired bone homeostasis. Strict monitoring is needed in order to early identify and treat these conditions.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Scatter plots used to investigate the relationship between lumbar BMD z-score and BMI (a), years of age (b), and treatment duration (c). Box and whisker plot to investigate the relationship between lumbar BMD z-score and race.
Figure 2
Figure 2
Box and whisker plot to investigate the relationship between femoral BMD z-score and race.
Figure 3
Figure 3
Scatter plots used to investigate the relationship between femoral BMD z-score and BMI (a) and treatment duration (b).
See this image and copyright information in PMC

References

    1. Mora S. Pediatric HIV infection and bone health an emerging challenge. Frontiers in Bioscience. 2010;E2(4):1265–1274. doi: 10.2741/e188. - DOI - PubMed
    1. Lima L. R., Krug R. d., Silva R. C., et al. Prediction of Areal Bone Mineral Density and Bone Mineral Content in Children and Adolescents Living With HIV Based on Anthropometric Variables. Journal of Clinical Densitometry. 2016;19(4):457–464. doi: 10.1016/j.jocd.2015.06.001. - DOI - PubMed
    1. Triant V. A., Brown T. T., Lee H., Grinspoon S. K. Fracture prevalence among human immunodeficiency virus (HIV)-infected versus non-HIV-infected patients in a large U.S. healthcare system. The Journal of Clinical Endocrinology & Metabolism. 2008;93(9):3499–3504. doi: 10.1210/jc.2008-0828. - DOI - PMC - PubMed
    1. Hansen A.-B. E., Gerstoft J., Kronborg G., et al. Incidence of low and high-energy fractures in persons with and without HIV infection: A Danish population-based cohort study. AIDS. 2012;26(3):285–293. doi: 10.1097/QAD.0b013e32834ed8a7. - DOI - PubMed
    1. CDC classification system for HIV infection. https://www.cdc.gov/mmwr/preview/mmwrhtml/00032890.htm.

LinkOut - more resources