Bone Metabolism in Men who Live with HIV Aged 50 years and Over: Impact of Infection Duration


Цитировать

Полный текст

Аннотация

Background:Early diagnosis and effective antiretroviral therapy (ART) lead to similar life expectancy in people living with HIV (PLWH) compared to the general population. This population faces problems such as decreased bone mineral density (BMD) and increased fracture risk. The aim of this study was to determine the prevalence of osteoporosis in men aged 50 years and over who were PLWH and to determine risk factors and changes in bone metabolism with bone turnover markers.

Methods:79 male PLWH aged 50 years and over were followed up in our outpatient clinic between May 2021 and October 2021. The patients’ demographic, clinical, laboratory, and DEXA data were analyzed. Serum levels of bone turnover markers were measured.

Results:The prevalence of osteopenia, osteoporosis, and normal BMD was found to be 55.7%, 13.9%, and 30.4%, respectively. A correlation was found between low BMD and low body mass index, elapsed time since diagnosis of HIV infection, high rate of use of ART, and long usage time of tenofovir disoproxil fumarate + protease inhibitor. A one-year increase in HIV infection duration was associated with an increased risk of low BMD by 1.246.

Conclusion:Compared to studies conducted on the general population, the prevalence of osteoporosis in male PLWH aged 50 years and older was two times higher. The limited effect of the duration of ART use on low BMD may be due to the patients' histories of replacement therapy. Therefore, to eliminate the negative effects of ART on BMD, it may be beneficial to start replacement therapy when necessary.

Об авторах

Bilge Caglar

Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa School of Medicine, Istanbul University

Автор, ответственный за переписку.
Email: info@benthamscience.net

Bilgul Mete

Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa School of Medicine, Istanbul University

Email: info@benthamscience.net

Pinar Kadioglu

Department of Endocrinology, Cerrahpasa School of Medicine, Istanbul University

Email: info@benthamscience.net

Kerim Sonmezoglu

Department of Department of Nuclear Medicine, Cerrahpasa School of MedicineNuclear Medicine, Istanbul University

Email: info@benthamscience.net

Iclal Bulut

Department of Radiology, Cerrahpasa School of Medicine, Istanbul University

Email: info@benthamscience.net

Nese Saltoglu

Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa School of Medicine, Istanbul University

Email: info@benthamscience.net

Gokhan Aygun

Department of Medical Microbiology, Cerrahpasa School of Medicine, Istanbul University

Email: info@benthamscience.net

Dildar Konukoglu

Department of Medical Biochemistry, Cerrahpasa School of Medicine, Istanbul University

Email: info@benthamscience.net

Hakan Yavuzer

Department of Geriatrics, Cerrahpasa School of Medicine, Istanbul University

Email: info@benthamscience.net

Sibel Kaya

Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa School of Medicine, Istanbul University

Email: info@benthamscience.net

Ilker Balkan

Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa School of Medicine, Istanbul University

Email: info@benthamscience.net

Ridvan Karaali

Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa School of Medicine, Istanbul University

Email: info@benthamscience.net

Emre Durcan

Department of Endocrinology, Cerrahpasa School of Medicine, Istanbul University

Email: info@benthamscience.net

Omer Tabak

Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa School of Medicine, Istanbul University

Email: info@benthamscience.net

Список литературы

  1. Mallon PWG. Aging with HIV. Curr Opin HIV AIDS 2014; 9(4): 428-35. doi: 10.1097/COH.0000000000000080 PMID: 24871090
  2. de Almeida LL, Ilha TASH, de Carvalho JAM, et al. Sarcopenia and its association with vertebral fractures in people living with HIV. Calcif Tissue Int 2020; 107(3): 249-56. doi: 10.1007/s00223-020-00718-y PMID: 32683475
  3. Tükenmez-Tigen E, Korten V. Effects of HIV infection and antiretroviral treatment on the development of osteopenia. Klimik Derg 2012; 25(2): 51-7.
  4. Hoy J. Bone disease in HIV: Recommendations for screening and management in the older patient. Drugs Aging 2015; 32(7): 549-58. doi: 10.1007/s40266-015-0279-4 PMID: 26123948
  5. Turkish endocrinology and metabolism association. osteoporosis and metabolic bone diseases diagnosis and treatment guide. Available from: https://temd.org.tr/kilavuzlar
  6. Biver E. Osteoporosis and HIV Infection. Calcif Tissue Int 2022; 110(5): 624-40. doi: 10.1007/s00223-022-00946-4 PMID: 35098324
  7. Powderly WG. Osteoporosis and bone health in HIV. Curr HIV/AIDS Rep 2012; 9(3): 218-22. doi: 10.1007/s11904-012-0119-7 PMID: 22581359
  8. Katzenstein TL, Wessman M, Moseholm E, et al. Prevalence of low bone mineral density among people living with HIV. Cogent Med 2021; 8(1): 1920667. doi: 10.1080/2331205X.2021.1920667
  9. Tuzun S, Eskiyurt N, Akarirmak U, et al. Incidence of hip fracture and prevalence of osteoporosis in Turkey: The FRACTURK study. Osteoporos Int 2012; 23(3): 949-55. doi: 10.1007/s00198-011-1655-5 PMID: 21594756
  10. Wattanachanya L, Sunthornyothin S, Apornpong T, et al. Bone mineral density among virologically suppressed Asians older than 50 years old living with and without HIV: A cross-sectional study. PLoS One 2022; 17(11): e0277231. doi: 10.1371/journal.pone.0277231 PMID: 36409740
  11. Chiţu-Tișu CE, Barbu EC, Lazăr M, Ion DA, Bădărău IA. Low bone mineral density and associated risk factors in HIV-infected patients. Germs 2016; 6(2): 50-9. doi: 10.11599/germs.2016.1089 PMID: 27482514
  12. Lima A, de Oliveira PR, Plapler PG, et al. Osteopenia and osteoporosis in people living with HIV: Multiprofessional approach. HIV AIDS 2011; 3: 117-24. doi: 10.2147/HIV.S6617 PMID: 22267944
  13. Carr A, Grund B, Neuhaus J, et al. Prevalence of and risk factors for low bone mineral density in untreated HIV infection: A substudy of the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial. HIV Med 2015; 16(S1): 137-46. doi: 10.1111/hiv.12242 PMID: 25711332
  14. Delpino MV, Quarleri J. Influence of HIV infection and antiretroviral therapy on bone homeostasis. Front Endocrinol 2020; 11: 502. doi: 10.3389/fendo.2020.00502 PMID: 32982960
  15. Aydın OA, Karaosmanoglu HK, Karahasanoglu R, Tahmaz M, Nazlıcan O. Prevalence and risk factors of osteopenia/osteoporosis in Turkish HIV/AIDS patients. Braz J Infect Dis 2013; 17(6): 707-11. doi: 10.1016/j.bjid.2013.05.009 PMID: 24076108
  16. Dutta D, Garga U, Gadpayle A, et al. Occurrence & predictors of osteoporosis & impact of body composition alterations on bone mineral health in asymptomatic pre-menopausal women with HIV infection. Indian J Med Res 2018; 147(5): 484-95. doi: 10.4103/ijmr.IJMR_1196_16 PMID: 30082573
  17. Bonjoch A, Figueras M, Estany C, et al. High prevalence of and progression to low bone mineral density in HIV-infected patients: A longitudinal cohort study. AIDS 2010; 24(18): 2827-33. doi: 10.1097/QAD.0b013e328340a28d PMID: 21045635
  18. Moran CA, Neale Weitzmann M, Ofotokun I. Bone loss in HIV infection. Curr Treat Options Infect Dis 2017; 9(1): 52-67. doi: 10.1007/s40506-017-0109-9 PMID: 28413362
  19. Birabaharan M, Kaelber DC, Karris MY. Bone mineral density screening among people with HIV: A population-based analysis in the United States. Open Forum Infect Dis 2021; 8(3): ofab081. doi: 10.1093/ofid/ofab081 PMID: 33796595
  20. Stellbrink HJ, Orkin C, Arribas JR, et al. Comparison of changes in bone density and turnover with abacavir-lamivudine versus tenofovir-emtricitabine in HIV-infected adults: 48-week results from the ASSERT study. Clin Infect Dis 2010; 51(8): 963-72. doi: 10.1086/656417 PMID: 20828304
  21. Correia IM, Navarro AM, Corrêa Cordeiro JF, et al. Bone mineral content estimation in people living with HIV: Prediction and validation of sex-specific anthropometric models. Int J Environ Res Public Health 2022; 19(19): 12336. doi: 10.3390/ijerph191912336 PMID: 36231634
  22. Walker Harris V, Brown TT. Bone loss in the HIV-infected patient: Evidence, clinical implications, and treatment strategies. J Infect Dis 2012; 205(Suppl 3): S391-8. doi: 10.1093/infdis/jis199 PMID: 22577213
  23. Dao CN, Patel P, Overton ET, et al. Low vitamin D among HIV-infected adults: Prevalence of and risk factors for low vitamin D Levels in a cohort of HIV-infected adults and comparison to prevalence among adults in the US general population. Clin Infect Dis 2011; 52(3): 396-405. doi: 10.1093/cid/ciq158 PMID: 21217186
  24. Brown TT, Qaqish RB. Antiretroviral therapy and the prevalence of osteopenia and osteoporosis: A meta-analytic review. AIDS 2006; 20(17): 2165-74. doi: 10.1097/QAD.0b013e32801022eb PMID: 17086056
  25. Brown TT, Moser C, Currier JS, et al. Changes in bone mineral density after initiation of antiretroviral treatment with tenofovir disoproxil fumarate/emtricitabine plus atazanavir/ritonavir, darunavir/ritonavir, or raltegravir. J Infect Dis 2015; 212(8): 1241-9. doi: 10.1093/infdis/jiv194 PMID: 25948863
  26. Kruger MJ, Nell TA. Bone mineral density in people living with HIV: A narrative review of the literature. AIDS Res Ther 2017; 14(1): 35. doi: 10.1186/s12981-017-0162-y PMID: 28747190
  27. Compston J. Osteoporosis and fracture risk associated with HIV infection and treatment. Endocrinol Metab Clin North Am 2014; 43(3): 769-80. doi: 10.1016/j.ecl.2014.05.001 PMID: 25169566

Дополнительные файлы

Доп. файлы
Действие
1. JATS XML
Скачать

© Bentham Science Publishers, 2024