J Korean Med Sci.  2013 Jun;28(6):827-832. 10.3346/jkms.2013.28.6.827.

Prevalence and Risk Factors of Low Bone Mineral Density in Korean HIV-Infected Patients: Impact of Abacavir and Zidovudine

• Kim HS
• Chin BS
• Shin HS

• KMID: 2158028
• DOI: http://doi.org/10.3346/jkms.2013.28.6.827

Abstract

Low bone mineral density (BMD) is common in HIV-infected patients. We aimed to describe the prevalence of low BMD and risk factors in Korean HIV-infected patients and to assess the effects of antiretroviral therapy (ART) on BMD. We retrospectively evaluated 224 HIV infected-patients. The prevalence of osteopenia and osteoporosis were 41.5% and 12.9%. These were much higher in 53 patients aged 50 yr and older (52.8% and 34.0%). Older age, lower body mass index, and ART > 3 months were independent risk factors for low BMD. Osteoporosis was more prevalent in patients on the abacavir-based regimen for < 1 yr than > or = 1 yr; however, it was more prevalent in patients on the zidovudine-based regimen for > or = 1 yr than < 1 yr (P = 0.017). Osteoporosis in patients on the abacavir-based regimen was more common in the spine than in the femur (P = 0.01). Given such a high prevalence of low BMD, close monitoring of BMD for HIV-infected patients on ART is required. The different prevalence of osteoporosis over time and affected areas between two regimens suggest they may play roles in different mechanisms in bone loss.

Keyword

HIV; Acquired Immunodeficiency Syndrome; Bone Density; Abacavir; Zidovudine

MeSH Terms

Adult
Anti-HIV Agents/adverse effects/*therapeutic use
Asian Continental Ancestry Group
Body Mass Index
*Bone Density
Bone Diseases, Metabolic/*epidemiology/etiology
Dideoxynucleosides/adverse effects/*therapeutic use
Female
HIV Infections/*drug therapy/epidemiology/pathology
Humans
Male
Middle Aged
Odds Ratio
Osteoporosis/*epidemiology/etiology
Prevalence
Republic of Korea/epidemiology
Retrospective Studies
Risk Factors
Zidovudine/adverse effects/*therapeutic use
Anti-HIV Agents
Dideoxynucleosides
Zidovudine

Figure

• 

  Fig. 1 Prevalence of osteoporosis in patients on abacavir- and zidovudine-based regimens over time (*P value was adjusted for age, sex, BMI, PI cumulative exposure day, NNRTI cumulative exposure day).

• 

  Fig. 2 Prevalence of osteoporosis in patients on the abacavir- and zidovudine-based regimens according to the anatomical site.

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