Endocrine Abstracts

Objective: To study the impact of HBV related chronic liver disease (CLD) and its treatment with Tenofovir on bone health in Indian subjects.

Methods: This cross-sectional study included men between 18 and 60 years and comprised of three groups: Group 1 was treatment naïve HBV-related CLD (n=79), Group 2 – those with HBV-related CLD on tenofovir for at least 1 year duration (n=136), Group 3 – normal age, sex and BMI-matched healthy controls (n=58). Bone biochemistry and bone mineral density were studied.

Results: More subjects in Group 1 and Group 2 were found to have more similar proportion of subjects with vitamin-D deficiency and a higher serum C-Terminal telopeptide but fared worse when compared to age, sex and BMI-matched controls (Group 3). A lower mean BMD and a higher prevalence of low bone mass at the spine and forearm was found in treatment naïve patients with hepatitis B related CLD (Group 1) whereas the femoral neck was most affected in tenofovir-treated patients (Group 2), these however were lower at all three sites when compared to Group 3 (P<0.05). Age, BMI and a high viral load (>10,000) emerged as significant risk factors for low bone mass at femoral neck.

Conclusion: The impact of hepatitis B related CLD and its treatment on bone health is significant. Bone health need to be periodically evaluated in these subjects especially in older men who are lean and have a higher viral load. However, long-term follow-up studies are needed to look at the impact of treatment for adverse bone health in these subjects.