Bone deleterious effects of different nrtis in treatment-naïve HIV patients after 12 and 48 weeks of treatment

2021 ◽  
Vol 19 ◽  
Author(s):  
Patricia Atencio ◽  
Francisco Miguel Conesa-Buendía ◽  
Alfonso Cabello-Ubeda ◽  
Patricia Llamas-Granda ◽  
Ramón Pérez-Tanoira ◽  
...  
Keyword(s):  
Bone Markers ◽  
Marked Decrease ◽  
Mineral Density ◽  
Hiv Patients ◽  
Metabolic Bone ◽  
High Prevalence ◽  
Treatment Naïve ◽  
Tenofovir Alafenamide ◽  
A Prospective Study ◽  
Density Treatment

Background: Bone alterations have been observed in the course of HIV infection, characterized by a marked decrease in bone mineral density (BMD) and an increase in the frequency of fractures as a result of fragility. We aim to evaluate early changes in bone metabolic profile and the possible association with tenofovir and other nucleoside and nucleotide reverse transcriptase inhibitors (NRTIs) in treatment-naïve HIV patients. Methods: We conducted a prospective study in naïve HIV infected adults (under 50 years), separated into three groups according to NRTI therapy: tenofovir disoproxil fumarate (TDF); tenofovir alafenamide (TAF) and abacavir (ABC). BMD and epidemiological, immunological and metabolic bone parameters were evaluated. Bone markers were analyzed in plasma at baseline, 12 and 48 weeks after initiating treatment. Results: Average age of patients was 34.8 years (± 9.6). 92.4% of them with CD4 count > 200 cel/μL. At week 12 after starting treatment, both TDF [increase in PN1P (31.7%, p = 0.004), TRAP (11.1%, p = 0.003), OPN (19.3%, p = 0.045) and OC (38.6%, p = 0.001); decrease in OPG (-23.4%, p = 0.003)] and TAF [increase in 42.6% for CTX (p = 0.011), 27.3% for OC (p = 0.001) and 21% for TRAP (p = 0.008); decrease in OPG (-28.8%, p = 0.049)] presented a deep resorption profile compared to ABC, these differences in bone molecular markers, a tendency to equalize at week 48, where no significant differences were observed. Patients treated with TDF showed the greatest decrease in Z-score in both lumbar spine (LS) and femoral neck (FN) at week 48 without statistically significant differences. Conclusions: Treatment-naïve HIV patients have a high prevalence of low bone density. Treatment with TDF is associated with greater bone deterioration at 12 and 48 weeks. TAF seems to present similar early bone deterioration at 12 weeks which disappears at 48 weeks.

Osteoporosis and Bone Metabolism in Treatment-naive Primary Prostate Adenocarcinoma Patients

2018 ◽  
Vol 69 (5) ◽  
pp. 1099-1105
Author(s):  
Violeta Bojinca ◽  
Claudiu Popescu ◽  
Andra Rodica Balanescu ◽  
Serban Mihai Balanescu ◽  
Mihai Bojinca
Keyword(s):  
Bone Metabolism ◽  
Bone Markers ◽  
Prostate Adenocarcinoma ◽  
Continuous Variables ◽  
Mineral Density ◽  
X Ray ◽  
T Score ◽  
Primary Prostate Cancer ◽  
Treatment Naïve ◽  
Group A

The objectives of the study were to evaluate bone metabolism in primary prostate cancer (PCa) patients prior to any treatment and to compare estrogens and anti-androgens in terms of bone metabolism. The study prospectively included consecutive patients with primary PCa who were proposed for radical prostatectomy and androgen deprivation therapy (ADT; either estrogens-group E, or anti-androgens -group A) and age-matched controls. Bone markers (osteoprotegerin -OPG; osteocalcin; deoxypyridinoline) were measured before treatment and after 6 months. Bone mineral density (BMD) was measured by dual X-ray absorptiometry before treatment and after 12 months (osteoporosis was defined as a spine or hip T score � -2.5). Continuous variables are reported as mean � standard deviation. The study included 30 controls (aged 70 � 6 years), 15 patients treated with estrogens (aged 71 � 6 years) and 15 patients with anti-androgens (aged 72 � 5 years). At baseline, 0% of controls, 33.3% of group E (p = 0.002 versus controls) and 53.3% of group A (p = 0.0001 versus controls) had osteoporosis. In group E, compared to baseline, OPG (4.67 � 1.38 versus 5.27 � 1.89; p = 0.043) and DPD (6.85 � 3.24 versus 8.63 � 2.42; p = 0.008) increased, while spine (0.99 � 0.32 versus 0.94 � 0.31; p = 0.019) BMD decreased. In group A, compared to baseline, OPG (6.37 � 3.04 versus 5.02 � 1.12; p = 0.041), spine (1.03 � 0.15 versus 0.89 � 0.15; p = 0.0003) and hip (0.82 � 0.18 versus 0.75 � 0.17; p = 0.003) BMD decreased. Osteoporosis is prevalent among hormone-na�ve PCa patients. Estrogens are associated with an increase of serum OPG, while anti-androgens with a decrease of serum OPG. Irrespective of ADT type, BMD still decreases in primary PCa patients.

scholarly journals Adenosine Deaminase as a Biomarker of Tenofovir Mediated Inflammation in Naïve HIV Patients

2020 ◽  
Vol 21 (10) ◽  
pp. 3590
Author(s):  
Francisco Miguel Conesa-Buendía ◽  
Patricia Llamas-Granda ◽  
Patricia Atencio ◽  
Alfonso Cabello ◽  
Miguel Górgolas ◽  
...  
Keyword(s):  
Adenosine Deaminase ◽  
Monocyte Count ◽  
Hiv Viral Load ◽  
Hiv Patients ◽  
Gm Csf ◽  
Inflammatory Status ◽  
Cell Counts ◽  
Treatment Naïve ◽  
Csf Levels ◽  
Tenofovir Alafenamide

Plasma levels of adenosine deaminase (ADA), an enzyme that deaminates adenosine to inosine, are increased during inflammation. An increase in ADA activity occurs with lower human immunodeficiency virus (HIV) viral load and higher CD4+ T cell counts. We aimed to investigate the role of plasma ADA as a biomarker of inflammation in treatment-naïve HIV patients who received tenofovir or another nucleoside analog for comparison. Ninety-two treatment-naïve patients were included in the study and grouped by treatment, i.e., tenofovir disoproxil fumarate (TDF), tenofovir alafenamide (TAF) or Triumeq. ADA activity was measured in plasma and cytokines were analyzed by MILLIPLEX® MAP-Luminex® Technology. Plasma concentration of monocytes and neutrophils was measured at 0, 3, and 12 months post-treatment. Treatment-naïve HIV patients had increased ADA concentrations (over 15 U/L) that decreased after treatment with TAF and Triumeq, though this did not occur in TDF-treated patients. However, all groups exhibited a pro-inflammatory systemic profile at 12 months of treatment. Plasma GM-CSF levels decreased after 12 months of treatment in the TDF group, with a concomitant decrease in blood monocyte count, and a negative correlation with ADA values was found. In conclusion, ADA levels may be modulated by antiretroviral therapy in HIV patients, possibly affecting inflammatory status.

scholarly journals 318. Tenofovir Alafenamide (TAF) vs. Tenofovir Disoproxil Fumarate (TDF) in Hispanic/Latinx and Black Participants: Efficacy, Bone and Renal Safety Results from a Pooled Analysis of 7 Clinical Trials

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S168-S169
Author(s):  
Edwin DeJesus ◽  
Jaime Federico Andrade Villanueva ◽  
Jose Ramon Arribas Lopez ◽  
Cynthia Brinson ◽  
Gordon Crofoot ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Pooled Analysis ◽  
Retinol Binding Protein ◽  
Virologic Suppression ◽  
Mineral Density ◽  
Art Initiation ◽  
Treatment Naïve ◽  
Tenofovir Alafenamide ◽  
Renal Tubular ◽  
Hiv 1

Abstract Background People of color are underrepresented in clinical trials. TAF has shown improved renal and bone safety vs. TDF. We pooled 7 studies to evaluate efficacy/safety of TAF vs. TDF for ART initiation/switch in Hispanic/Latinx and Black participants. Methods Data from Hispanic/Latinx and Black adults who initiated/switched to TAF or TDF in 7 randomized trials (2 treatment-naïve, 5 suppressed switch) were analyzed. TAF-based regimens (elvitegravir/cobicistat/emtricitabine [FTC]/TAF, rilpivirine/FTC/TAF, FTC/TAF, or bictegravir/FTC/TAF) were compared with TDF-based regimens. Virologic suppression (VS; HIV-1 RNA < 50 c/mL, FDA snapshot) and % change in bone mineral density (BMD) and renal tubular biomarkers urine β-2-microglobulin (B2M):creatinine (Cr) ratio and retinol binding protein (RBP):Cr ratio are reported at W96. Results The pooled population (N = 5,825) included 1138 Hispanic/Latinx and 1324 Black participants. Treatment-naïve participants (n = 1,733) were 15% female, 25% Black, 19% Hispanic/Latino, with median age 34 years, HIV-1 RNA 4.6 log10 c/mL, CD4 405 cells/mm3. Switch participants (n = 4,092) were 13% female, 22% Black, 20% Hispanic/Latino, median age 45 years, CD4 653 cells/mm3. There was no difference in VS rate with TAF vs. TDF in any group. VS rate (TAF vs. TDF) in naïve participants: 88% vs. 84% (Hispanic/Latinx); 78 vs. 79% (Black); 87% vs. 85% (overall). VS (TAF vs. TDF) was well maintained in switch participants: 91% both arms (Hispanic/Latinx); 86% vs. 87% (Black); 90% vs. 88% (overall). TAF and TDF were well tolerated with few discontinuations due to adverse events (0.6–2%) in all groups. At W96 there was less impact on renal biomarkers in all groups initiating TAF (P < 0.001; table), and decreases in BMD were smaller (P < 0.005; table) vs. TDF. All groups switching from TDF to TAF experienced decreases in tubular proteinuria and improvements in BMD (both P < 0.001; table) at W96. Conclusion Hispanic/Latinx and Black participants who initiated/switched to TAF had significantly improved bone and renal parameters vs. TDF, with similar VS rates at W96. Efficacy and biomarkers were similar to the overall study population. These data in >2,400 Hispanic/Latinx and Black PLH demonstrate noninferior efficacy and safety advantages with TAF vs. TDF. Disclosures All authors: No reported disclosures.

scholarly journals Optimal timing for initiation of antiretroviral therapy: a prospective study on treatment naive HIV patients

2012 ◽  
Vol 12 (S1) ◽  
Author(s):  
Jaya Chakravarty ◽  
Avinash Singh ◽  
Anup Singh ◽  
Madhukar Rai ◽  
Anoop Gupta ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Prospective Study ◽  
Optimal Timing ◽  
Hiv Patients ◽  
Treatment Naïve ◽  
A Prospective Study

High Prevalence of Hypovitaminosis D in Morocco: Relationship to Lifestyle, Physical Performance, Bone Markers, and Bone Mineral Density

2009 ◽  
Vol 38 (6) ◽  
pp. 444-451 ◽  
Author(s):  
Fadoua Allali ◽  
Sihame El Aichaoui ◽  
Hamza Khazani ◽  
Boubker Benyahia ◽  
Bouchra Saoud ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Physical Performance ◽  
Bone Mineral ◽  
Bone Markers ◽  
Hypovitaminosis D ◽  
Mineral Density ◽  
High Prevalence

scholarly journals POS1118 THE RELEVANCE OF OSTEOPOROSIS DIAGNOSIS AND TREATMENT FOR DOCTORS WORKING IN THE FIELD OF PHYSICAL AND REHABILITATION MEDICINE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 838.2-838
Author(s):  
L. Marchenkova ◽  
V. Vasileva
Keyword(s):  
Diagnostic Procedures ◽  
Rehabilitation Medicine ◽  
Medical Problem ◽  
Medical Rehabilitation ◽  
Mineral Density ◽  
Medical Specialties ◽  
Treatment And Prevention ◽  
Medical Institutions ◽  
Physical And Rehabilitation Medicine ◽  
High Prevalence

Background:There is a high prevalence of osteoporosis (OP) among patients of the older age undergoing rehabilitation. Therefore, it is obvious that physicians working in the field of physical and rehabilitative medicine should be well oriented in this medical problem.Objectives:to study the relevance of the problem of osteoporosis (OP) for physicians working in the field of physical and rehabilitation medicine, their awareness of the main methods of diagnosis, treatment and prevention of this disease, as well as the frequency of their use in daily clinical activities.Methods:A cross-type study was carried out using a questionnaire survey. The study included 157 doctors (M-34, F-123) of 8 medical specialties working in 27 specialized medical institutions on the profile of “medical rehabilitation. The questionnaire for doctors consisted of 21 items of special questions.Results:90.45% of the surveyed doctors believed that the problem of OP is relevant for their clinical activities, 100% of the respondents indicated that the presence of OP significantly affects the rehabilitation prognosis and 95.54% - on the degree of effectiveness of medical rehabilitation. According to the respondents, patients with OP make up on average 30.0% [20.0; 50.0] (0-90) of the total flow of patients. 92.36% (145/157) of doctors indicated that they know the risk factors for OP, 98.73% (155/157) - methods for diagnosing OP, 68.79% (108/157) - methods for treating OP, 80.25 % (126/157) - methods of preventing OP, 47.13% (74/157) - what is FRAX. However, 35.01% (55/157) of the respondents considered their level of awareness of the problem sufficient for managing patients with OP. Diagnostic procedures for OP are recommended by all endocrinologists (100%) and the majority of traumatologists (72.73%), gynecologists (66.67) and cardiologists (64.28%), as well as on average half (50%) neurologists and therapists. Endocrinologists (100%), gynecologists (66.67%) and therapists (60%) are mainly involved in the treatment of OP. 32.48% (51/157) of physicians have ever referred their patients to a bone mineral density assessment.Conclusion:Conclusion. The problem of OP is relevant for the clinical activities of specialists in physical and rehabilitation medicine, and there is the need for advanced training on the problem of OP among these specialists.Disclosure of Interests:None declared.

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