Osteoporosis and osteopenia are not associated with T-cell activation in older cART-treated HIV-infected patients.
Neth J Med
; 75(4): 138-144, 2017 May.
Article
en En
| MEDLINE
| ID: mdl-28522769
ABSTRACT
BACKGROUND:
A higher risk of developing osteopenia/ osteoporosis has been seen in HIV-infected patients. We compared HIV-infected patients, all treated with combination antiretroviral therapy (cART), with a low bone mineral density (BMD) (T-score < -1) to those with a normal BMD (T-score > -1), examining the relation with T-cell activation and bone turnover markers (c-terminal telopeptide (CTX) and procollagen type 1 amino-terminal propeptide (P1NP)).METHODS:
In this single visit pilot study, bone turnover markers, T-cell activation (CD38 + HLA - DR +) and senescence (CD57+) of T cells were measured in patients who had previously undergone dual energy X-ray absorptiometry scanning.RESULTS:
All study participants (n = 16) were male, on cART, with a median age of 61 years (IQR 56-66). Nine patients had osteopenia/osteoporosis. When comparing the patients with osteopenia/osteoporosis with those with a normal BMD, no differences in activation and senescence were found. A relation was seen between higher bone formation (P1NP) and patients who were on cART for longer. The median length of cART use was 5.5 years (IQR 4.5-7.8), with all patients on nucleoside reverse transcriptase inhibitors, 88% on tenofovir, 63% on non-nucleoside reverse transcriptase inhibitors (NNRTIs) and 38% on protease inhibitors. Osteopenia/osteoporosis was seen in 100% of the patients on protease inhibitors versus 30% of those on NNRTIs.CONCLUSION:
This study did not find an association between activated T cells and BMD, thus did not explain the higher prevalence of osteopenia/osteoporosis in HIV-infected patients. Interestingly, this small pilot showed that cART might influence BMD, with a possible negative effect for protease inhibitors and a possible protective effect for NNRTIs. These results warrant further investigation.
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Bases de datos:
MEDLINE
Asunto principal:
Osteoporosis
/
Enfermedades Óseas Metabólicas
/
Linfocitos T
/
Infecciones por VIH
/
Fármacos Anti-VIH
Tipo de estudio:
Etiology_studies
/
Prevalence_studies
/
Risk_factors_studies
Límite:
Aged
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Neth J Med
Año:
2017
Tipo del documento:
Article
País de afiliación:
Países Bajos