Purpose
We
determined the prevalence and correlates of low bone mineral density (BMD) in
HIV-infected South Africans as there is a paucity of such data from Africa.
Methods
BMD
and serum 25-hydroxyvitamin D were measured in HIV-positive participants on
antiretroviral therapy (ART) and in those not yet on ART (ART-naïve).
Results
We
enrolled 444 participants [median age 35(IQR: 30, 40) years; 77% women]. BMD
was low (z score <-2SD) in 17% and 5% of participants at the lumbar spine
and total hip, respectively. Total hip [0.909 (SD 0.123) vs 0.956 (SD 0.124)
g/cm2, p = 0.0001] and
neck of femur BMD [0.796 (SD 0.130) vs 0.844 (SD 0.120) g/cm2, p = 0.0001] were lower in
the ART, compared to the ART-naïve group. Vitamin D deficiency was present in
15% of participants and was associated with efavirenz use [adjusted OR 2.04
(95% CI 1.01 to 4.13)]. In a multivariate linear regression, exposure to
efavirenz or lopinavir-based ART was associated with lower total hip BMD,
whereas higher weight, being male and higher vitamin D concentration were
associated with higher total hip BMD (adjusted R2 = 0.28). Age, weight,
sex, and the use of efavirenz-based ART were independently associated with
lumbar spine BMD (adjusted R2 = 0.13).
Conclusions
Vitamin D status, use of efavirenz or
lopinavir/ritonavir, weight, age and sex are significantly associated with
lower BMD in this young cohort of HIV-infected South Africans.
Purchase full article at: http://goo.gl/cw1BYN
By:
Joel A. Dave, Naomi S. Levitt
Division of Diabetic Medicine
and Endocrinology, Department of Medicine, University of Cape Town, Cape Town,
South Africa
Karen Cohen, Gary Maartens
Division of Clinical
Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South
Africa
Lisa K. Micklesfield
UCT/MRC Research Unit for
Exercise Science and Sports Medicine, Department of Human Biology, University
of Cape Town, Cape Town, South Africa
Lisa K. Micklesfield
MRC/Wits Developmental Pathways
for Health Research Unit, Department of Paediatrics, Faculty of Health
Sciences, University of the Witwatersrand, Johannesburg, South Africa
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