Factors Associated with Bone Mineral Density and Bone Resorption Markers in Postmenopausal HIV-Infected Women on Antiretroviral Therapy: A Prospective Cohort Study

• Published in: Nutrients Vol. 13; no. 6; p. 2090
• Main Authors: Ellis, Christa, Kruger, Herculina S, Viljoen, Michelle, Dave, Joel A, Kruger, Marlena C
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 01.06.2021; MDPI
• Subjects: Alcohol; Alfacalcidol; Analysis; Antiretroviral agents; Antiretroviral drugs; Antiretroviral therapy; Antiviral agents; black; Body mass index; Bone density; Bone mineral density; Bone resorption; Bones; Calcifediol; Calciferol; calcium; Cohort analysis; Collagen (type I); Density; Drug therapy; Dual energy X-ray absorptiometry; Ethnicity; Exercise; Food; Fractures; Highly active antiretroviral therapy; HIV; HIV (Viruses); HIV infection; HIV patients; Human immunodeficiency virus; Markers; Metabolism; Normal distribution; Osteoporosis; Parathyroid; Parathyroid hormone; Physical activity; Post-menopause; postmenopausal; Postmenopausal women; Questionnaires; Rheumatoid arthritis; Risk factors; Sociodemographics; Spine; Vitamin D; Womens health; South Africa; Sub-Saharan Africa
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu13062090

The study aimed to determine factors associated with changes in bone mineral density (BMD) and bone resorption markers over two years in black postmenopausal women living with human immunodeficiency virus (HIV) on antiretroviral therapy (ART). Women (n = 120) aged > 45 years were recruited from Potchefstroom, South Africa. Total lumbar spine and left femoral neck (LFN) BMD were measured with dual energy X-ray absorptiometry. Fasting serum C-Telopeptide of Type I collagen (CTx), vitamin D and parathyroid hormone were measured. Vitamin D insufficiency levels increased from 23% at baseline to 39% at follow up. In mixed linear models serum CTx showed no change from baseline to end (p = 0.363, effect size = 0.09). Total and LFN BMD increased significantly over two years, but effect sizes were small. No significant change in spine BMD over time was detected (p = 0.19, effect size = 0.02). Age was significantly positively associated with CTx over time, and negatively with total and LFN BMD. Physical activity (PA) was positively associated with LFN BMD (p = 0.008). Despite a decrease in serum vitamin D, BMD and CTx showed small or no changes over 2 years. Future studies should investigate PA interventions to maintain BMD in women living with HIV.