接受稳定抗逆转录病毒治疗的老年艾滋病毒感染者的肾骨轴:GS-US-104-0423研究的亚分析

IF 1.3 4区 医学 Q4 INFECTIOUS DISEASES
Elena Alvarez, Lucy Campbell, Willard Tinago, Alejandro Garcia-Leon, Ian Walsh, Jennifer J Brady, Keith Burling, Sebastian Noe, Marie F Neuville, Francois Jouret, Farid Jamshidian, Hiba Graham, Martin Rhee, Paddy W Mallon, Frank A Post
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引用次数: 1

摘要

背景:艾滋病毒感染者(PLWH)的低骨密度(BMD)数据主要来自年轻人;关于抗逆转录病毒治疗(ART)和肾骨轴改变与老年PLWH骨密度的关系,我们知之甚少。方法:对50岁以上男性和绝经后感染HIV的女性进行横断面研究。根据富马酸替诺福韦二氧吡酯(TDF)和蛋白酶抑制剂(PI)的使用情况,将抗逆转录病毒治疗暴露分为四组:非TDF/非PI、非TDF/PI、TDF/非PI和TDF/PI。采用双x线骨密度仪(DXA)测定骨密度。在储存的血浆和尿液样本中分析骨转换/调节标志物和肾小管功能。使用logistic回归模型探讨ART暴露与骨密度的骨/肾生物标志物之间的关系。结果:247例(中位[IQR]年龄57[53,65]岁;47%的女性;黑人占13%;CD4计数643[473,811]个细胞/mm3;98%的HIV RNA < 200拷贝/mL)。骨转换和肾小管功能与ART暴露有显著差异。在对人口统计学和传统肾/骨危险因素进行调整的分析中,暴露于TDF和PI与股骨颈低骨密度风险增加4倍相关,暴露于TDF和/或PI与腰椎低骨密度风险增加3倍相关。ART与低骨密度之间的关系并未因进一步调整骨转换或肾小管功能指标而改变。结论:低骨密度与ART暴露之间的关联(TDF与非TDF,增强与未增强的第三剂)受骨和肾生物标志物调整的影响最小。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The renal-bone axis in older people living with HIV on stable antiretroviral therapy: A sub-analysis of the GS-US-104-0423 study.

Background: Data on low bone mineral density (BMD) in people living with HIV (PLWH) are mainly derived from younger adults; little is known about how antiretroviral therapy (ART) and alterations in the renal-bone axis relate to BMD in older PLWH.

Methods: Cross-sectional study of men > 50 years and post-menopausal women with HIV. Antiretroviral therapy exposure was stratified into four groups based on use of tenofovir disoproxil fumarate (TDF) and protease inhibitors (PI): non-TDF/non-PI, non-TDF/PI, TDF/non-PI, and TDF/PI. Bone mineral density was measured by dual X-ray absorptiometry (DXA). Bone turnover/regulatory markers and renal tubular function were analysed in stored plasma and urine samples. The association of ART exposure and bone/renal biomarkers on BMD was explored using logistic regression models.

Results: 247 individuals (median [IQR] age 57 [53, 65] years; 47% female; 13% of Black ethnicity; CD4 count 643 [473, 811] cells/mm3; and 98% with HIV RNA < 200 copies/mL) were included. Bone turnover and renal tubular function differed significantly by ART exposure. In analyses adjusted for demographic and traditional renal/bone risk factors, exposure to TDF and PI was associated with a fourfold greater risk of low BMD at the femoral neck and exposure to TDF and/or PI with a threefold greater risk of low BMD at the lumbar spine. The relationship between ART and low BMD was not altered by further adjustment for bone turnover or renal tubular function markers.

Conclusions: The associations between low BMD and ART exposure (TDF vs. non-TDF and boosted vs. unboosted third agents) were minimally affected by adjustments for bone and kidney biomarkers.

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来源期刊
Antiviral Therapy
Antiviral Therapy 医学-病毒学
CiteScore
2.60
自引率
8.30%
发文量
35
审稿时长
4-8 weeks
期刊介绍: Antiviral Therapy (an official publication of the International Society of Antiviral Research) is an international, peer-reviewed journal devoted to publishing articles on the clinical development and use of antiviral agents and vaccines, and the treatment of all viral diseases. Antiviral Therapy is one of the leading journals in virology and infectious diseases. The journal is comprehensive, and publishes articles concerning all clinical aspects of antiviral therapy. It features editorials, original research papers, specially commissioned review articles, letters and book reviews. The journal is aimed at physicians and specialists interested in clinical and basic research.
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