ECE2020 ePoster Presentations Bone and Calcium (65 abstracts)
Bone mineral density in patients with human immunodeficiency virus infection. Assessment of vitamin D status, treatment and other associated risk factors
Joaquin Puerma Ruiz 1 , Alba Martín González 1 , Jose Napky 1 , Mercedes Gutiérrez Oliet 1 , Gema Villa López 1 , Rafael Rubio García 2 , Federico Pulido 2 , David Lora 3 , Gonzalo Alló 1 & Guillermo Martínez Diaz-Guerra 1
1Endocrinología y Nutrición, Hospital 12 De Octubre, Madrid, Spain; 2Departamento de Enfermedades Infecciosas, Medicina Interna, Hospital 12 De Octubre, Madrid, Spain; 3Hospital 12 De Octubre, Estadística e Investigación, Madrid, Spain
Introduction: In patients with human immunodeficiency virus (HIV) infection, the prevalence of osteoporosis is higher in comparison with the general population. Anti-retroviral therapy (ART) use seems to be a possible risk factor there is also high prevalence of vitamin D deficiency among people living with HIV.
Objectives: To describe bone mineral density (BMD) status in HIV-infected patients as well as its associated risk factors such as vit D levels.
Materials and methods: Retrospective observational study with a sample of 107 HIV-infected patients who underwent BMD evaluation.
Results: Baseline population results are summarized on the following table:
| Características Basales | n (%), media (DS) |
| Males | 79 (73.83%) |
| Age | 55 ± 7.3 a–os (a) |
| Weight | 70.74 ± 14.03 kg |
| Body mass index (BMI) | 25.23 ± 4.6 kg/m2 |
| Smokers | 47 (43.9%) |
| Time since HIV-infected diagnosis | 17.3 ± 7.3 a |
| Antiretroviral therapy: | |
| • Tenofovir disproxil (TED) | 91 (85%) |
| ○ Treatment years | 9.9 ± 5.04 a |
| • Tenofovir alafenamide (TAF) | 15 (14.01%) |
| ○ Treatment years | 1.83 ± 2.12 a |
| • Protease inhibitors (PI) | 31 (28.97%) |
| ○ Treatment years | 7.41 ± 5.3 a |
| Parathyroid hormone (PTH) | 47.5 ± 26.5 ng/dl |
| Serum 25-OH-vitamin D (25-OH-VitD) | 27 ± 12.6 ng/ml |
| • Insufficiency (20Ð30 ng/ml) | 43(40.1%) |
| • Deficiency (<20 ng/ml). | 29 (27%) |
| Femoral neck | |
| • T-score | −1.3 ± 0.9 |
| • Z-score | −0.5 ± 0.9 |
| Hip: | |
| • T-score | −0.8 ± 0.8 |
| • Z-score | −0.3 ± 0.9 |
| Lumbar spine: | |
| • T-score | −1.4 ± 1.2 |
| • Z-score | −0.8 ± 1.25 |
| Osteopenia: | |
| ○ Femoral neck: | 74 (69.1%) |
| ○ Lumbar spine: | 45 (42%) |
| Osteoporosis: | |
| ○ Femoral neck: | 10 (9.3%) |
| ○ Lumbar spine: | 20(18.6%) |
| Osteoporosis treatment | 6 (5%) solo bifosfonatos |
| Vit D treatment | 68 (63%) |
| Calcium supplements | 2 (1.8%) |
| Evaluation by osteoporosis unit | 21 (19.62%) |
A statistically significant association was found between combined treatment with TED+PI and lower femoral neck and hip BMD and femoral neck osteopenia. Longer duration of treatment was associated with femoral neck osteopenia and lower BMD at the femoral neck and lumbar spine. 25-OH-VitD deficiency was associated with overall lower BMD at the femoral neck and hip.
Conclusions: HIV-infected patients show a high prevalence of osteopenia and osteoporosis. Combined use of TED+PI, longer duration of ART treatment and long-standing HIV infection could be possible risk factors for this finding. There is a high prevalence of vitamin D insufficiency/deficiency despite a high prescription of supplementation.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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