Prevalence of low bone mineral density in Human Immunodeficiency Virus-infected patients and its correlation with other determinants

Swati M. Mahajan, R. Raina, A. Jhobta
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Abstract

Background: The patients infected with human immunodeficiency virus (HIV) are potentially at risk of low bone mineral density (BMD). The present study was done to find out the prevalence of low BMD in HIV-infected patients and its correlation with other factors such as gender, body mass index (BMI), CD4 count, and highly active antiretroviral therapy (HAART). Methods: This was an observational cross-sectional study conducted in a tertiary care center for 1 year period. A total of 127 HIV-infected patients were evaluated for BMD by dual-energy X-ray absorptiometry (DEXA) scans at two sites lumbosacral spine and bilateral neck femur. Correlation with other factors was also studied. Results: The diagnosis of low BMD was established in 105 (82.67%) patients. Osteoporosis (44.1%) was more common than osteopenia (38.6%) at the lumbosacral spine. The mean T score of the DEXA lumbar spine and bilateral neck femur was observed to be ?2.113 and ?1.379, respectively. Males (88.73%) had low BMD than females (75%). Approximately 94.5% of subjects having BMI <18 had low BMD in contrast to 80.8% among subjects having BMI >18. After treatment, 47 patients had CD4 count <400 and 80 > 400. Forty-three patients out of 47 (91.5%) had low BMD and 62 out of 80 (77.5%) had low BMD. Conclusion: Low BMD is prevalent in HIV-infected subjects. Low BMI, persistently low CD4 count, tenofovir containing HAART regimen showed a positive correlation with low BMD. Hence, HIV infection should be considered as a risk factor for bone disease.
人类免疫缺陷病毒感染患者的低骨密度患病率及其与其他决定因素的相关性
背景:感染人类免疫缺陷病毒(HIV)的患者存在低骨密度(BMD)的潜在风险。本研究旨在了解hiv感染患者的低BMD患病率及其与性别、体重指数(BMI)、CD4计数和高效抗逆转录病毒治疗(HAART)等因素的相关性。方法:这是一项在三级保健中心进行的为期1年的观察性横断面研究。通过双能x线吸收仪(DEXA)扫描腰骶骨和双侧股骨颈两个部位,对127例hiv感染患者的骨密度进行了评估。并对其与其他因素的相关性进行了研究。结果:105例(82.67%)诊断为低骨密度。腰骶棘骨质疏松(44.1%)比骨质减少(38.6%)更为常见。DEXA腰椎和双侧股骨颈T评分平均值分别为2.113和1.379。男性(88.73%)骨密度低于女性(75%)。大约94.5%的受试者BMI为18。治疗后,47例患者CD4计数为400。47例患者中有43例(91.5%)骨密度低,80例患者中有62例(77.5%)骨密度低。结论:低骨密度在hiv感染者中普遍存在。低BMI、持续低CD4计数、含替诺福韦的HAART方案与低BMD呈正相关。因此,艾滋病毒感染应被视为骨病的一个危险因素。
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