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7th Annual Conference Of The British HIV Association [BHIVA]27 – 29 April 2001, The Hove Centre, Brighton |
[AUTHOR(S):] AL Moore1, A Vashist1, CA Sabin2, AN Phillips1, JWW Studd1, MA Johnson2
1 Centre for HIV, Royal Free and University College Medical School, and 2 Chelsea and Westminster Hospital, London, UK
BHIVA Conf 2001 Apr 27-29;7:O21
OBJECTIVE: Abnormal BMD is increasingly reported in HIV positive patients although the aetiology, clinical significance and treatment of this condition are not yet known. It is therefore currently difficult to rationalise screening for abnormal BMD other than as part of research protocols. We aimed to assess the value of serum markers of bone turnover as a screening tool for abnormal (BMD) in HIV-positive subjects.
METHODS: Serum levels of a marker of bone formation (PICP) and bone resorption (ICTP) were compared against standard dual-energy X-ray absorptiometry (DEXA) scans. Marker values were designated abnormal if above the mean population value for PICP and if above the median for ICTP, with DEXA scans categorised according to T score (>1 SD below the general population mean being classified as 'abnormal' and >2.5 SD below the mean as osteoporotic).
RESULTS: A total of 95 patients had both DEXA scan and serum markers available, 69 (73%) having 'abnormal' DEXA scans and 13 (19%) of these being osteoporotic. The sensitivity of the bone marker test for abnormal BMD was 68%, specificity 50%, positive predictive value 78% and negative predictive value 37%. In assessing the test for benefit in screening for osteoporosis, sensitivity was 69%, specificity 38%, positive predictive value 15% and negative predictive value 89%.
CONCLUSIONS: The predictive value of the combined marker test is such that we cannot accurately identify those at risk of abnormal BMD as determined by DEXA scan. These markers are more likely to be useful when used in conjunction with DEXA scans in longitudinal monitoring of bone turnover.
PRESENTING AUTHOR: AL Moore
010427
O21
Copyright © 2001 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD