Impact of antiretroviral therapy on bone metabolism markers in HIV-seropositive patients

• Published in: Bone (New York, N.Y.) Vol. 57; no. 1; pp. 62 - 67
• Main Authors: de Menezes Barbosa, Erika Grasiela Marques, de Paula, Francisco Jose Albuquerque, Machado, Alcyone Artioli, de Assis Pereira, Francisco, Barbosa, Fernando, Navarro, Anderson Marliere
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Inc 01.11.2013; Elsevier
• Subjects: Absorptiometry, Photon; Adult; Anti-Retroviral Agents - therapeutic use; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiretroviral Therapy, Highly Active; Antiviral agents; Biological and medical sciences; Body Composition - drug effects; Bone Density - drug effects; Bone Diseases, Metabolic - etiology; Bone Diseases, Metabolic - metabolism; Bone metabolism; Calcium - metabolism; Cross-Sectional Studies; Fundamental and applied biological sciences. Psychology; HIV; HIV Infections - drug therapy; HIV Infections - metabolism; Human viral diseases; Humans; Infectious diseases; Male; Medical sciences; Orthopedics; Osteopenia; Osteoporosis; Osteoporosis - etiology; Osteoporosis - metabolism; Pharmacology. Drug treatments; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Young Adult; Osteoporosis; ART; HIV; Bone metabolism; Osteopenia; Immunopathology; Antiretroviral agent; Seropositivity; Diseases of the osteoarticular system; Retroviridae; AIDS; Metabolism; Immune deficiency; Lentivirus; Infection; Virus; Chemotherapy; Treatment; Viral disease; Morphology; Antiviral; Bone; Human immunodeficiency virus
• ISSN: 8756-3282; 1873-2763; 1873-2763
• DOI: 10.1016/j.bone.2013.07.019

To evaluate the impact of antiretroviral therapy (ART) on bone and mineral metabolism and to determine the occurrence of osteopenia and/or osteoporosis in HIV-infected patients taking ART or not. A cross-sectional study was conducted on 50 HIV-seropositive adult men treated with or not treated with ART. Dual energy X-ray absorptiometry (DXA) was performed and biochemical analyses of the following markers were carried out: FSH, LH, testosterone, total calcium, phosphorus (Pi), magnesium (Mg), albumin, 24h calcium, creatinine, urea, parathormone (PTH), insulin-like growth factor 1 (IGF-I), 25 hydroxyvitamin D (25-OH-D), osteocalcin, and urinary deoxypyridinoline (DPD). The participants were divided into two groups according to ART use or not: Group A, 10 treatment-naive subjects; Group B, ART use for >2years, subdivided into: Group B1, 10 subjects treated with protease inhibitors (PIs) and nucleoside/nucleotide analog reverse transcriptase inhibitors (NRTIs) and Group B2, 10 subjects treated with NRTIs and non-nucleoside analog reverse transcriptase inhibitors (NNRTIs); and Group C, subjects treated with ART <2years, subdivided into: Group C1, 10 subjects treated with PIs and NRTIs and Group C2, 10 subjects treated with NRTIs and NNRTIs. The values of the bone formation marker, osteocalcin, were normal in all groups, whereas urinary DPD values were increased in all groups. Whole body DXA revealed a higher percentage of osteopenia (80%) in Group B2. Lumbar spine DXA showed osteoporosis in Groups A and B1 (10%) and total femur DXA in Group B2 (10%). The increased bone reabsorption marker indicated a high reabsorptive activity of bone tissue. These data indicate a greater osteoclastic activity in bone loss in HIV-infected patients on ART. •We investigated the influence of duration of use of different ART regimens and the incidence of bone disease.•We evaluated body composition and dietary intake of calcium in HIV-infected men to check association with bone mass.•We evaluated the bone mineral density and biochemical markers of bone formation and resorption in bone mass reduction.•We evaluate the impact of HAART on the existence of changes in bone and mineral metabolism.