scholarly journals Immediate Initiation of Antiretroviral Therapy for HIV Infection Accelerates Bone Loss Relative to Deferring Therapy: Findings from the START Bone Mineral Density Substudy, a Randomized Trial

2017 ◽  
Vol 32 (9) ◽  
pp. 1945-1955 ◽  
Author(s):  
Jennifer F Hoy ◽  
Birgit Grund ◽  
Mollie Roediger ◽  
Ann V Schwartz ◽  
John Shepherd ◽  
...  
Sexual Health ◽  
2011 ◽  
Vol 8 (4) ◽  
pp. 493 ◽  
Author(s):  
Aoife G. Cotter ◽  
Patrick W. G. Mallon

Now more than ever, the management of age-related problems, from cardiovascular morbidity to bone pathology, is increasingly relevant for HIV physicians. Low bone mineral density (BMD) and fractures are more common in HIV-infected patients. Although a multifactorial aetiology underlies this condition, increasing evidence suggests a role for antiretroviral therapy in low BMD, especially upon initiation. This review will detail the epidemiology, pathogenesis, diagnosis and management of osteoporosis and low BMD in HIV-infected patients, with particular emphasis on aging.


2020 ◽  
Vol 6 (01) ◽  
pp. 18-23
Author(s):  
Tutan Das ◽  
Bhagyabati Devi ◽  
Ningthoukhongjam Reema ◽  
Thangjam Gautam Singh

Abstract Introduction Human immunodeficiency virus (HIV) is a disease that affects millions of people globally and affects almost all the body systems including bone metabolism. Derangement of bone mineral density (BMD) in HIV patients is well established in international literature but least studied in India. Therefore, this study aims to determine the association between BMD change and HIV infection with or without antiretroviral therapy (ART) and compare the different regimens of ART. Materials and Methods The cross-sectional study was conducted at the Department of Medicine and ART Center of Regional Institute of Medical Sciences, Imphal, India. A total of 50 HIV patients were screened by a central dual-energy X-ray absorptiometry (DEXA) examination for measuring BMD. Correlation of BMD with a CD4 count, and different ART regimens were also studied. Results In our study, majority of the patients (29 [58%]) had low BMD. Of the 29 patients, 18 (36%) had osteopenia and 11 (22%) had osteoporosis. Of the ART naïve patients, 81.8% have reduced BMD. Among different ART regimens, tenofovir-based regimes were mostly associated with low BMD (52.4%). A statistically significant association between low CD4 count and low BMD was found. Conclusion Our study concluded that HIV infection is associated with bone loss and low BMD in people living with HIV (PLHIV) irrespective of its treatment with ART. PLHIV are at a greater risk of bone loss secondary to decreased BMD. Among the ART regimens, tenofovir-based regimens are mostly associated with low BMD. Therefore, all HIV patients should be screened by DEXA scan for BMD status, and timely intervention should be started.


2020 ◽  
Author(s):  
Lungwani Muungo

Although it is well established that estrogen deficiencycauses osteoporosis among the postmenopausalwomen, the involvement of estrogen receptor (ER) in itspathogenesis still remains uncertain. In the presentstudy, we have generated rats harboring a dominantnegative ERa, which inhibits the actions of not only ERabut also recently identified ERb. Contrary to our expectation,the bone mineral density (BMD) of the resultingtransgenic female rats was maintained at the same levelwith that of the wild-type littermates when sham-operated.In addition, ovariectomy-induced bone loss wasobserved almost equally in both groups. Strikingly, however,the BMD of the transgenic female rats, after ovariectomized,remained decreased even if 17b-estradiol(E2) was administrated, whereas, in contrast, the decreaseof littermate BMD was completely prevented byE2. Moreover, bone histomorphometrical analysis ofovariectomized transgenic rats revealed that the higherrates of bone turnover still remained after treatmentwith E2. These results demonstrate that the preventionfrom the ovariectomy-induced bone loss by estrogen ismediated by ER pathways and that the maintenanceof BMD before ovariectomy might be compensatedby other mechanisms distinct from ERa and ERbpathways.


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