Tinago, W;
Cotter, AG;
Sabin, C;
Macken, A;
Kavanagh, E;
Brady, J;
McCarthy, G;
... HIV UPBEAT Study Group, .; + view all
(2017)
Predictors of longitudinal change in bone mineral density in a cohort of HIV-positive and negative subjects.
AIDS
, 31
(5)
pp. 643-652.
10.1097/QAD.0000000000001372.
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Abstract
OBJECTIVE: Although low bone mineral density (BMD) is prevalent in HIV, changes in BMD over time remain unclear. We aimed to compare rates of, and factors associated with, BMD change between HIV-positive and HIV-negative subjects. METHODS: In a prospective, 3-year cohort, HIV-positive and HIV-negative subjects provided annual demographic and clinical data, fasting bloods and dual x-ray absorptiometry (DXA). Using longitudinal mixed models we compared and determined predictors of rate of change in BMD. RESULTS: Of 384 subjects (45.8% HIV-positive), 120 contributed two and 264 contributed three BMD measurements. Those with HIV were younger (median (IQR) 39 (34-46) vs 43 (35-50) years; p=0.04), more often male (61% vs 46%; p = 0.003) and less likely Caucasian (61% vs 82%; p < 0.001). Although BMD was lower in those with HIV, BMD declined in both groups, with non-significant between-group difference in rate of BMD change over time.Within the HIV group, starting ART within 3 months of enrolment was associated with greater BMD decline at all anatomical sites (all p < 0.001). Age >30 years, Caucasian ethnicity, and not being on ART during follow-up were associated with greater decline and higher parathyroid hormone associated with a smaller decline in BMD at the femoral neck. We found no association between BMD change and exposure to tenofovir disoproxil fumarate or protease inhibitors. CONCLUSIONS: We observed no difference in rate of BMD decline regardless of HIV status and in HIV positive subject, having started ART within the previous three months was the only factor associated with greater BMD decline at all 3 sites.
| Type: | Article |
|---|---|
| Title: | Predictors of longitudinal change in bone mineral density in a cohort of HIV-positive and negative subjects. |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1097/QAD.0000000000001372 |
| Publisher version: | http://doi.org/10.1097/QAD.0000000000001372 |
| Language: | English |
| Additional information: | Copyright © 2016 Wolters Kluwer Health, Inc. This is the accepted manuscript version of this article published in Aids; the final published version of record can be found at http://dx.doi.org/10.1097/QAD.0000000000001372. |
| Keywords: | Antiretroviral therapy; bone mineral density; HIV; longitudinal change. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1537308 |
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