Antiretroviral-naïve HIV-infected patients had lower bone formation markers than HIV-uninfected adults

ABSTRACT

There are limited studies regarding bone health among people living with HIV (PLHIV) in Asia. We compared bone mineral density (BMD), serum 25-hydroxyvitamin D (25(OH)D) status and bone turnover markers (serum procollagen type1 N-terminal propeptide (P1NP), osteocalcin (OC) and C-terminal cross-linking telopeptide of type1 collagen) among 302 antiretroviral therapy (ART) naive PLHIV compared to 269 HIV-uninfected controls from Thailand. People aged ≥30 years, with and without HIV infection (free of diabetes, hypertension, and active opportunistic infection) were enrolled. BMD at the lumbar spine, total hip, and femoral neck were measured using Hologic DXA at baseline and at 5 years. We analyzed BMD, serum 25(OH)D levels, and bone turnover markers at the patients’ baseline visit. PLHIV were 1.5 years younger and had lower BMI. PLHIV had higher mean serum 25(OH)D level and similar BMD to the controls. Interestingly, PLHIV had significantly lower bone formation (serum P1NP and OC), particularly those with low CD4 count. Only a few participants had low bone mass. ARV naïve middle-aged PLHIV did not have lower BMD or lower vitamin D levels compared to the controls. However, PLHIV had lower bone formation markers, particularly those with low CD4 count. This finding supports the benefit of early ART.

KEYWORDS:

• Bone mineral density
• bone markers
• HIV
• Asia

Acknowledgements

First and foremost, we would like to thank our patients because without them, we would not have any data to report. We also would like to thank the Thai Red Cross AIDS Research Centre, HIV-NAT and Queen Savang Vadhana Memorial Hospital staff for their strong commitment to the study and hard work.

Disclosure statement

AA participated in a company sponsored speaker’s bureau from Jensen-Cilag, Gilead and Bristol-Meyer Squibb. The rest of the authors declare that they have no conflict of interest.

Additional information

Funding

This work was mainly supported by the ViiV Healthcare; Thai Red Cross AIDS Research Centre (TRC-ARC); Government research budget 2015–2016 [grant number GRB_APS_12_58_30_09 and GRB_APS_04_59_30_03]Ratchadapiseksompotch Fund, Faculty of Medicine, Chulalongkorn University: [grant number RA61/008]. All of the sponsors had no role on the study design, data collection, data analysis and manuscript writing.