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Fifth International CongressDrug Therapy in HIV Infection22-26 October, 2000
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REDUCED BONE MINERAL DENSITY IN HIV POSITIVE INDIVIDUALS
A.L. Moore, A, Vashist1, A. Mocroft, A.N. Phillips, J. Studd1 and M.A. Johnson
Centre for HIV, Royal Free and University College Medical School, London NW3 2PF; 1 Chelsea & Westminster Hospital, London SW10 9NH, UK
Int Cong Drug Therapy HIV 2000 Oct 22-26;5:Abstract No. PL8.7
AIDS 2000, Oct 22-26;14(Suppl. 4); S11
HAART has dramatically improved the prognosis for patients with HIV. Duration of exposure to antiretroviral agents is increasing and previously unrecognised toxicities emerging. Recently the association between protease inhibitors and reduced bone density has been described. This study aims to investigate the prevalence of reduced bone density amongst patients at the Royal Free hospital and to establish associated demographic and clinical characteristics. Patients who responded to posters advertising the study completed a questionnaire and underwent DEXA scanning. The data presented represents preliminary findings using STATA 6.
Of the 72 HIV positive patients who have to date undergone DEXA scans, 71% are male, 74% Caucasian and 53% homosexual. Median time since diagnosis of HIV is 4.9 years, age 39 and 66% are currently on/ have ever had antiretroviral therapy. 35% are current smokers. Median BMI was 24.1 kg/m2, CD 4 count 375 × 106/l and RNA 3.6 log copies/ml at the time of DEXA scan. Prevalence of reduced lumbar spine density was 64% using the T score, (greater than 1SD below the mean peak density for sex and race matched controls), and 50% using the Z score, (greater than 1SD below the mean density for sex, race and aged matched controls). Eight percent of patients had an osteoporotic lumbar spine, (T score greater than 2.5 SD below the mean).
Table PL8.7 Odds Ratio for reduced lumbar spine density, T score < –1.0
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| Variable | Crude OR (95% CI, P) | Adjusted OR (95%CI, P) | |
| Ever on antiretrovirals | 4.20(1.48–11.90; P < 0.001) | 3.08 (0.99–9.56. P = 0.05) | |
| Per 100 increase CD4 | 0.87 (0.74–1.03, P = 0.11) | ||
| Per year older | 1.03 (0.97–1.10, P = 0.30) | ||
| Per year HIV positive | 0.97 (0.91–1.03, P = 0.34) | ||
| Ever smoker | 0.67 (0.25–1.79, P = 0.42) | ||
| Increase in BMI | 0.96 (0.81–1.15, P = 0.68) | ||
| Lipodystrophy | 1.12 (0.63–1.99, P = 0.70) | ||
| Female | 1.19 (0.41–3.46, P = 0.75) | ||
| Non-Caucasian 1.15 | (0.37–3.57, P = 0.81) |
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The prevalence of reduced bone density in this HIV positive population is high and our results suggest evidence of an association with use of antiretroviral treatment. Further analysis, particularly of different treatment regimens, on a larger sample is ongoing.
Presenting author: A.L. Moore
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2000-10-22
PL8-7
Originally published in AIDS Volume 14, Supplement 4 and hosted with permission of the publisher Lippincott Williams & Wilkins, 250 Waterloo Road, London, SE1 8RD, UK. Tel: +44 (0)20 7981 0700 Fax: +44 (0) 7981 0701
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