Frequency of osteopenia and osteoporosis in men and women living with HIV/Aids: an observational study

Bruno Augusto Aguilar,Dalmo Roberto Lopes Machado,Emerson Sebastião,Anderson Marliere Navarro,André Pereira Dos Santos,Euripedes Bardanulfo Gonçalves Gomide

doi:10.11606/issn.2176-7262.rmrp.2021.168968

Abstract

Aims: To identify the frequency in changes of bone metabolism, including below the average value for age, osteopenia, and osteoporosis, in people living with HIV/AIDS (PLWHA) and to compare the frequency of factors associated with bone mineral density (BMD) and body composition between sex. Methods: This observational study assessed 106 PLWHA (65 male) recruited from the University Hospital of Ribeirão Preto Medical School from 2013 to 2014. BMD was measured using Dual Energy X-ray Absorptiometry (DXA). Standard deviation values for Z- and T-score proposed by the International Society for Clinical Densitometry were adopted to classify participants below the average value for age, osteopenia, and osteoporosis. Qui-square and Fischer’s exact tests were employed to compare males and females based on their factors associated with BMD reduction. Results: Fifty-two (49%) PLWHA presented at least one diagnosis for below the average value for age, osteopenia, and osteoporosis, being 37 (57%) and 15 (37%) male and female, respectively. Frequency of alcohol consumption was higher in males (n=20; 30.8%) than females (n=05; 12.2%) (p=0.028). Conclusions: A high rate of PLWHA showed changes in bone metabolism, with a higher frequency in males. The frequency of alcohol consumption was higher in males, and it may partially explain the possible causes of the increased rates of bone metabolism changes observed in this group. This information may help develop strategies for reducing the frequency of diagnosis for below the average value for age, osteopenia, osteoporosis improving quality of life in PLWHA.

Highlights

Access to free of cost antiretroviral therapy in Brazil has contributed to reducing the number of deaths due to complications associated with Human Immunodeficiency Virus (HIV)[1,2]
The availability and access to such therapy treatment have positively impacted life expectancy in people living with HIV/AIDS (PLWHA)
Beyond the frequency of factors associated with bone mineral density (BMD) reduction in PLWHA, bone demineralization is potentiated by HIV infection and the use of cART17

Summary

Introduction

Access to free of cost antiretroviral therapy (cART) in Brazil has contributed to reducing the number of deaths due to complications associated with Human Immunodeficiency Virus (HIV)[1,2]. The availability and access to such therapy treatment have positively impacted life expectancy in people living with HIV/AIDS (PLWHA). Life expectancy in PLWHA has increased 37 additional years[3]. This creates a new challenging scenario where PLWHA are aging with HIV infection. There is evidence of the high prevalence of comorbidities in this population, including a reduction in bone mineral density (BMD)[4]. The frequency of factors associated with BMD reduction includes sex, advanced age, time of HIV diagnosis, high viral load, decrease in CD4+ T cell count, time of exposure to cART, use of tobacco and frequency of alcoholic drinks, and low physical activity level[5,6]. In terms of the antiretroviral classes from cART associated-BMD reduction, the protease inhibitors (PIs) are specially highlighted[7]

Methods

Results

Discussion

Conclusion