[The impact of highly active antiretroviral therapy on bone mineral density in human immunodeficiency virus infected patients].

ABSTRACT

OBJECTIVE: To evaluate the influence of highly active antiretroviral therapy (HAART)on bone mineral density(BMD) of human immunodeficiency virus (HIV) infected patients and correlating clinical factors. METHODS: The clinical data from 2007 to 2008 were analyzed, including 50 patients treated with HAART (named treated group), 12 HIV-infected antiretroviral-naive patients (named untreated group) and 20 healthy people (named control group). Lumbar, femoral neck, femur, femoral greater trochanter and whole body BMD were measured by dual energy X-ray absorptiometry. The data were respectively analyzed. RESULTS: There were 19(38.0%) patients with osteopenia and 1 (2.0%) patient with osteoporosis in the treated group. There were 6 (50.0%) patients with osteopenia and 2 (16.7%) patient with osteoporosis in the untreated group. There were 5 (25.0%) patients with osteopenia, no one with osteoporosis in the control group. The prevalence of osteopenia/osteoporosis was statistically higher in the untreated group than that in the control group (P=0.02). The BMD of femur, femoral neck and greater trochanter [(0.97±0.14), (0.91±0.13), (0.76±0.12) g/cm2] in the HIV-infected group (including the treated and untreated group) were significantly lower than that in the control group [(1.04±0.12), (0.98±0.14), (0.84 ± 0.11) g/cm2, P<0.05]. There were no significantly differences in the BMD between the untreated group and the treated group. In the treated group, osteopenia/osteoporosis correlated with body weight less than 60 kg (r=0.074, P=0.004) and the viral load before HAART (r=5.103, P=0.021). CONCLUSIONS: The prevalence of osteopenia and osteoporosis in antiretroviral-naive HIV-infected patients is higher. The BMD of HIV-infected patients are reduced compared with the healthy people. The BMD is similar among HIV-infected patients irrespective of antiretroviral treatment. Body weight less than 60 kg and the viral load before HAART are the risk factors of osteopenia/osteoporosis for the HIV-infected antiretroviral patients.