Bone Loss More Common in HIV

People with HIV are at a greater risk of bone disease, a new study shows, though it is unclear why. Nonetheless, the findings emphasize the need to apply strategies that prevent bone demineralization and to closely monitor bone mass density in this population, said Dr. Anna Bonjoch of the Lluita Contra la SIDA Foundation in Barcelona, Spain.

In the study, Bonjoch evaluated 671 patients who previously had at least one dual-energy X-ray absorptiometry scan. Twenty-three percent had osteoporosis, the brittle bone disease that can raise the risk of fractures, and another 48 percent had osteopenia, abnormally low bone mass that can progress to osteoporosis.

Half the study participants were 42 or younger. Among 105 patients with two or more scans and at least five years of follow-up, 47 percent showed progressive bone demineralization (18 percent to osteopenia and 29 percent to osteoporosis).

"Factors associated with bone loss and progression were age (odds ratio [OR] 1.07; 95 percent confidence interval [CI] 1.05-1.08; P
The risk factors comport with previous studies, though the rate of bone loss is significantly higher, said Dr. Todd Brown of Johns Hopkins University, who was not affiliated with the study. Though patients with bone loss may simply have been more likely to get the scans, Brown said, "The percentage of patients with osteoporosis with HIV infection is probably higher than you would expect in an HIV-negative population."

The study, "High Prevalence and Progression to Low Bone Mineral Density in HIV-Infected Patients: A Longitudinal Cohort Study," was published in AIDS (2010;24(18):2827-2833).

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