Measurement of bone mineral density in hiv-infected individuals who are not considered as a specific risk group for bone mineral densitometry screening

Abstract

Objective: As HIV-infected individuals continue to live longer with antiretroviral therapy (ART), systemic metabolic complications are also becoming more frequent. HIV-infected patients who have ART have a 2-6% reduction in bone mineral density (BMD) over the first two years. This reduction in BMD is thought to be due to the complex relationship between the virus itself, ART and the usual risk factors of osteoporosis. We aimed to investigate the possibility that the decrease in BMD occurred at younger ages in HIV-infected individuals, and to show the factors that affect it. Methods: A total of 72 HIV-infected patients who did not have osteopenia or osteoporosis diagnosis or treatment previously, who had not had a history of fragile fracture, symptomatic hy-pogonadism and steroid use, and who applied to the Infectious Diseases and Clinical Microbiology Outpatient Clinic between February and July 2017 were evaluated cross-sectionally. Pre-menopausal women and <50-year-old men were included in the study. The BMD was measured at the femoral neck, lumbar spine and total body using dual-energy x-ray absorptiometry (DEXA) technique. Results: Of the patients who participated in the study, 90.3% were male, 9.7% were female and the average age was 38; 100% recieved tratment and their HIV-RNAs were below the detectable level, mean nadir CD4+ T lymphocyte count was 346.5 cells/ mm3, mean CD4+ T lymphocyte count was 616 cells/mm3. The mean body mass index (BMI) of the patients was 23.4 kg/mm2, 61.1% were smoker and 41.7% were using alcohol. According to lumbar vertebra Z score, 19.4% of the patients were found to have “bone mass lower than expected according to chronological age”. There was a significant relationship between low BMD and low BMI. There was no statistically significant relationship between gender, smoking and alcohol use, nadir and actual CD4+ T lymphocyte count, tenofovir disoproxil fumarate (TDF) use and duration (p>0.05). Conclusions: Low BMD in HIV-infected individuals may occur at an early age.