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Stable bone mineral density over 6 years in HIV‐infected men treated with highly active antiretroviral therapy (HAART)

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Objective  Most longitudinal studies of bone mineral density (BMD) in HIV‐infected cohorts have been of short duration, typically 1–2 years. Some studies, especially of cohorts treated with highly active antiretroviral therapy (HAART), report short‐term stable or increasing BMD, but other studies, often in cohorts initiating HAART, report short‐term losses in BMD. We assessed BMD changes over the medium term in HIV‐infected men already established on HAART at baseline.

Design  Six‐year, prospective, longitudinal study.

Subjects  Forty‐four HIV‐infected men treated with HAART and 37 uninfected, healthy controls.

Measurements  Participants had measurements of BMD at baseline, 2 and 6 years.

Results  In the HIV‐infected men at baseline, the mean age was 49 years, the mean duration of infection was 8 years, and the mean duration of HAART was 50 months. Over 6 years of follow‐up, there was a greater increase in lumbar spine BMD (5·3%, 95% CI 3·8–6·5%) in the HIV‐infected men compared with controls (0·3%, 95% CI −1·0 to 1·6%), P < 0·001. There was no difference between the groups in the change in BMD over time at the total hip (HIV group: −0·6%, 95% CI −1·7 to 0·4%, controls −1·0%, 95% CI −2·2 to 0%, P = 0·8) or at the total body (HIV group, 0·3%, 95% CI −0·3 to 1·0%; controls, 0·5%, 95% CI −0·2 to 1·1%, P = 0·15). Lean mass increased in the HIV group, but not in the controls.

Conclusions  There was no evidence of accelerated bone loss over 6 years in middle‐aged, HIV‐infected men treated with HAART. For such patients, routine monitoring of BMD is not necessary over the short/medium term.
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Document Type: Research Article

Affiliations: 1: Department of Medicine, University of Auckland 2: Department of Infectious Diseases, Auckland City Hospital

Publication date: May 1, 2012

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