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Current HIV Research

Editor-in-Chief

ISSN (Print): 1570-162X
ISSN (Online): 1873-4251

Research Article

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

Author(s): Bilge Caglar*, Emre Durcan, Ridvan Karaali, Ilker Inanc Balkan, Sibel Yildiz Kaya, Hakan Yavuzer, Dildar Konukoglu, Gokhan Aygun, Nese Saltoglu, Iclal Nur Bulut, Kerim Sonmezoglu, Pinar Kadioglu, Bilgul Mete and Omer Fehmi Tabak

Volume 22, Issue 1, 2024

Published on: 24 January, 2024

Page: [65 - 71] Pages: 7

DOI: 10.2174/011570162X273667231213061301

Price: $65

Abstract

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.

Graphical Abstract

[1]
Mallon PWG. Aging with HIV. Curr Opin HIV AIDS 2014; 9(4): 428-35.
[http://dx.doi.org/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.
[http://dx.doi.org/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.
[http://dx.doi.org/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.
[http://dx.doi.org/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.
[http://dx.doi.org/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.
[http://dx.doi.org/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.
[http://dx.doi.org/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.
[http://dx.doi.org/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.
[http://dx.doi.org/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.
[http://dx.doi.org/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.
[http://dx.doi.org/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.
[http://dx.doi.org/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.
[http://dx.doi.org/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.
[http://dx.doi.org/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.
[http://dx.doi.org/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.
[http://dx.doi.org/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.
[http://dx.doi.org/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.
[http://dx.doi.org/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.
[http://dx.doi.org/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.
[http://dx.doi.org/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.
[http://dx.doi.org/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.
[http://dx.doi.org/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.
[http://dx.doi.org/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.
[http://dx.doi.org/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.
[http://dx.doi.org/10.1016/j.ecl.2014.05.001] [PMID: 25169566]

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