Bone Mass Density disorders and HIV infection: a prospective evaluation of BMD and its predictors in the HIV cohort at Pescara General Hospital.


ABSTRACT
Introduction HAART increased patients’ survival, but dismetabolic events increased in parallel. Bone disorders like osteopenia/osteoporosis are on the rise. We designed a prospective study to evaluate bone mass density (BMD) and risk factors for BMD disorders in all consecutive HIV infected patients attending our Institution. Methods All consecutive HIV infected patients in follow up at our Institution are being enrolled. Clinical and behavioral evaluations are considered at enrollment and will be reconsidered 24 months apart. HAART, Nadir and current CD4 T-cell counts, current HIV viremia are being retrieved with other metabolic and hormonal parameters. BMD is measured by dual X-ray absorptiometry (DXA) of femur and lumbar spine and by Quantitative UltraSound (QUS) of the heel. Stata Software package 9 has been used for statistical analyses. Results Main outcomes were: DXA T-Scores and Z-Scores for lumbar spine and femur; QUS T-Scores, Z-Scores and QUS stiffness for heel. All major outcomes were significantly related to BMI and length of HAART. Gainful employment, taking other drugs in addition to HAART, presence of ACL, hypertension and occurrence of any type of bone fracture emerged as possibly related additional risk or protective factors for BMD reduction. Discussion Our observation seems to confirm the importance of studying bone metabolism in a HIV infected patients. Lower BMIs and longer duration of HAART were confirmed associated to a lower BMDs. A link between BMD reduction and working activity may have emerged. Our final analysis on data from the whole sample will provide a more significant contribution.
Keywords: Osteopenia/osteoporosis; HIV; Bone mass density (BMD).


Articolo presente in – HAART and correlated pathologies n. 4

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