Accelerated bone mineral loss in HIV-infected patients receiving potent antiretroviral therapy
Open accessAbstract
BACKGROUND: The use of highly active antiretroviral therapy (HAART) has been associated with multiple metabolic complications whose pathogenesis is poorly understood at the present time. METHODS: We performed a cross-sectional analysis of whole-body, lumbar spine (L1-L4) and proximal femur bone mineral density in 112 male subjects (HIV-infected patients on HAART that included a protease inhibitor, HIV-infected patients not receiving a protease inhibitor and healthy seronegative adults) using dual energy x-ray absorptiometry. RESULTS: Men receiving protease inhibitors had a higher incidence of osteopenia and osteoporosis according to World Health Organization definitions: relative risk = 2.19 (95% confidence interval 1.13-4.23) (P = 0.02). Subjects receiving protease inhibitors had greater central: appendicular adipose tissue ratios than the other two groups (P < 0.0001). There was no relationship between the central: appendicular fat ratio and the lumbar spine or proximal femur bone mineral density t- or z- scores, suggesting that osteoporosis and body fat redistribution are independent side effects of HAART. CONCLUSIONS: Osteopenia and osteoporosis are unique metabolic complications associated with protease inhibitor-containing potent antiretroviral regimens, that appear to be independent of adipose tissue maldistribution.
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HIV patients display reduced BMD and increased risk of osteoporosis.
“HIV patients are consistently reported to display reduced BMD and increased risk of developing osteoporosis, although there is some divergence as to whether this phenomenon occurs due to the HIV retrovirus or protease inhibitor therapy (Tebas et al, 2000; Bruera et al, 2003; Amiel et al, 2004; Brown & Qaqish, 2006).”
From The struggle of a good friend getting old: cellular senescence in viral responses and therapy (2021) · cites this paper as Tebas et al, 2000
There is divergence as to whether reduced BMD in HIV patients is due to HIV retrovirus or protease inhibitor therapy.
“HIV patients are consistently reported to display reduced BMD and increased risk of developing osteoporosis, although there is some divergence as to whether this phenomenon occurs due to the HIV retrovirus or protease inhibitor therapy (Tebas et al, 2000; Bruera et al, 2003; Amiel et al, 2004; Brown & Qaqish, 2006).”
From The struggle of a good friend getting old: cellular senescence in viral responses and therapy (2021) · cites this paper as Tebas et al, 2000
Cites
Palella, F. J., Delaney, K. M., Moorman, A. C., Loveless, M. O., Fuhrer, J., Satten, G. A., Aschman, D. J., & Holmberg, S. D. (1998) · New England Journal of Medicine · doi:10.1056/nejm199803263381301 · Cited by 9,393 · see citing works
Bone density at various sites for prediction of hip fractures
Cummings, S. R., Browner, W., Cummings, S. R., Black, D. M., Nevitt, M. C., Browner, W., Genant, H. K., Cauley, J., Ensrud, K., Scott, J., et al. (1993) · The Lancet · doi:10.1016/0140-6736(93)92555-8 · Cited by 2,446 · see citing works
Carr, A. D., Samaras, K., Þórisdóttir, A. S., Kaufmann, G. R., Chisholm, D. J., & Cooper, D. A. (1999) · The Lancet · doi:10.1016/s0140-6736(98)08468-2 · Cited by 1,490 · see citing works
Pre-Existing Fractures and Bone Mass Predict Vertebral Fracture Incidence in Women
Ross, P. D., Davis, J. W., Epstein, R. S., & Wasnich, R. D. (1991) · Annals of Internal Medicine · doi:10.7326/0003-4819-114-11-919 · Cited by 1,107 · see citing works
Adverse effects of reverse transcriptase inhibitors
Brinkman, K., ter Hofstede, H. J. M., Burger, D. M., Smeitink, J. A. M., & Koopmans, P. P. (1998) · AIDS · doi:10.1097/00002030-199814000-00004 · Cited by 839 · see citing works
Guidelines for diagnosis and management of osteoporosis
Kanis, J. А., Delmas, P. D., Burckhardt, P., Cooper, C. C., & Torgerson, D. J. (1997) · Osteoporosis International · doi:10.1007/bf01623782 · Cited by 789 · see citing works
HIV-1 protease inhibitors. A review for clinicians
Deeks, S. G. (1997) · JAMA · doi:10.1001/jama.277.2.145 · Cited by 686 · see citing works
“Buffalo hump” in men with HIV-1 infection
Lo, J. C.-M., Mulligan, K. M., Tai, V., Algren, H. A., & Schambelan, M. (1998) · The Lancet · doi:10.1016/s0140-6736(97)11443-x · Cited by 565 · see citing works
Behrens, G. M. N., Dejam, A., Schmidt, H., Balks, H. J., Brabant, G. E., Körner, T., Stoll, M., & Schmidt, R. E. (1999) · AIDS · doi:10.1097/00002030-199907090-00001 · Cited by 515 · see citing works
Severe premature coronary artery disease with protease inhibitors
Henry, K., Melroe, H., Huebsch, J. A., Hermundson, J., Levine, C., Swensen, L., & Daley, J. (1998) · The Lancet · doi:10.1016/s0140-6736(05)79053-x · Cited by 509 · see citing works
Body Composition and Endocrine Function in Women with Acquired Immunodeficiency Syndrome Wasting1
Grinspoon, S. K., Corcoran, C. P., Miller, K. K., Biller, B. M. K., Askari, H., Wang, E., Hubbard, J. L., Anderson, E. J., Basgoz, N. O., Heller, H. M., et al. (1997) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.82.5.3907 · Cited by 207 · see citing works
Aukrust, P., Haug, C. J., Ueland, T., Lien, E., Müller, F., Espevik, T., Bollerslev, J., & Frøland, S. S. (1999) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.84.1.5417 · Cited by 185 · see citing works
Bone mineral density predicts non-spine fractures in very elderly women
Nevitt, M. C., Johnell, O., Black, D. M., Ensrud, K. E., Genant, H. K., Cummings, S. R., & Cummings, S. R. (1994) · Osteoporosis International · doi:10.1007/bf01622192 · Cited by 162 · see citing works
Deeks, S. G., Smith, M. D., Holodniy, M., & Kahn, J. S. (1997) · PubMed · doi:10.1001/jama.1997.03540260059037 · Cited by 156 · see citing works
Severe Diabetes Associated with Protease Inhibitor Therapy
Visnegarwala, F., Krause, K. L., & Musher, D. M. (1997) · Annals of Internal Medicine · doi:10.7326/0003-4819-127-10-199711150-00016 · Cited by 138 · see citing works
Insulin Resistance in HIV Protease Inhibitor–Associated Diabetes
Yarasheski, K. E., Tebas, P., Sigmund, C., Dagogo-Jack, S. E., Bohrer, A., TURK, J. W., Halban, P. A., Cryer, P. E., & Powderly, W. G. (1999) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/00126334-199907010-00005 · Cited by 127 · see citing works
Self-citationNew-Onset Diabetes Mellitus Associated with Use of Protease Inhibitor
Eastone, J. A., & Decker, C. F. (1997) · Annals of Internal Medicine · doi:10.7326/0003-4819-127-10-199711150-00017 · Cited by 125 · see citing works
Bone Mineral Density in Patients with Human Immunodeficiency Virus Infection
Paton, N. I., Macallan, D. C., Griffin, G. E., & Pazianas, M. (1997) · Calcified Tissue International · doi:10.1007/s002239900288 · Cited by 112 · see citing works
Osteonecrosis of the femoral head in patients receiving HIV protease inhibitors
Meyer, D., Behrens, G. M. N., Schmidt, R. E., et al. (1999) · AIDS · doi:10.1097/00002030-199906180-00025 · Cited by 81 · see citing works
Multiple site avascular necrosis in HIV infected patients.
Gerster, J. C., Cámus, J. P., Chave, J. P., et al. (1991) · PubMed · Cited by 55 · see citing works
Update: Trends in AIDS Incidence— United States, 1996
(1998) · Archives of Dermatology · doi:10.1001/archderm.134.1.122 · Cited by 37 · see citing works
Avascular necrosis of the medial femoral condyle in HIV-infected patients.
Stovall, D., & Young, T. R. (1995) · PubMed · Cited by 22 · see citing works
[Bilateral avascular necrosis of the femur head in an HIV-positive male].
Gonzalez, L. M., Martin, L., Ocaña, C. J., et al. (1994) · PubMed · Cited by 4 · see citing works
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Schambelan, M., Benson, C. A., Carr, A., Currier, J. S., Dubé, M. P., Gerber, J. G., Grinspoon, S. K., Grunfeld, C., Kotler, D. P., Mulligan, K., et al. (2002) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/00126334-200211010-00001 · Cited by 379 · see citing works
Self-citationBedimo, R., Maalouf, N. M., Zhang, S., Drechsler, H., & Tebas, P. (2012) · AIDS · doi:10.1097/qad.0b013e32835192ae · Cited by 324 · see citing works
Self-citationIncreased Risk of Fragility Fractures among HIV Infected Compared to Uninfected Male Veterans
Womack, J. A., Goulet, J. L., Gibert, C., Brandt, C., Chang, C. C., Gulanski, B., Fraenkel, L., Mattocks, K., Rimland, D., Rodriguez-Barradas, M. C., et al. (2011) · PLoS ONE · doi:10.1371/journal.pone.0017217 · Cited by 261 · see citing works
BMD Is Reduced in HIV-Infected Men Irrespective of Treatment
Amiel, C., Ostertag, A., Slama, L., Baudoin, C., N'Guyen, T., Lajeunie, E., Neit-Ngeilh, L., Rozenbaum, W., & De Vernejoul, M. (2004) · Journal of Bone and Mineral Research · doi:10.1359/jbmr.0301246 · Cited by 150 · see citing works
The struggle of a good friend getting old: cellular senescence in viral responses and therapy
Kohli, J., Veenstra, I., & Demaria, M. (2021) · The EMBO Reports · doi:10.15252/embr.202052243 · Cited by 52 · see citing works
Casado, J. L., Bañon, S., Andrés, R., Perez-Elías, M. J., Moreno, A., & Moreno, S. (2014) · Osteoporosis International · doi:10.1007/s00198-013-2506-3 · Cited by 44 · see citing works
Sharma, A., Cohen, H. W., Freeman, R., Santoro, N., & Schoenbaum, E. E. (2011) · Maturitas · doi:10.1016/j.maturitas.2011.08.003 · Cited by 39 · see citing works
Dalla Grana, E., Rigo, F., Lanzafame, M., Lattuada, E., Suardi, S., Mottes, M., Valenti, M. T., & Dalle Carbonare, L. (2019) · Frontiers in Endocrinology · doi:10.3389/fendo.2019.00302 · Cited by 17 · see citing works
- Authors
- Tebas, P., Powderly, W. G., Claxton, S., Marin, D., Tantisiriwat, W., Teitelbaum, S. L., & Yarasheski, K. E.
- Affiliations
- Washington University in St. Louis (US)
- Corresponding author
- Tebas, Pablo
- Venue
- AIDS
- Published
- 2000-03
- Volume
- 14
- Issue
- 4
- Pages
- F63-F67
- ISSN
- 0269-9370 (ISSN-L)
- PMC
- PMC3170993
- OpenAlex
- W2025683142
- Cited by
- 532
- References
- 23
- Citations by year
- 2025: 7 · 2024: 3 · 2023: 5 · 2022: 10 · 2021: 15 · 2020: 10 · 2019: 11 · 2018: 13 · 2017: 16 · 2016: 16 · 2015: 18 · 2014: 21 · 2013: 26 · 2012: 21
- FWCI
- 43.12
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- AIDS (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Allergy and Infectious Diseases (U01AI025903, AI-25903)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK-54163, R56DK049393, R01DK054163, DK49393, R01DK049393)
- Topics
- Health Sciences › Medicine › Emergency Medicine › HIV-related health complications and treatments
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS drug development and treatment
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Keywords
- HIV infection, highly active antiretroviral therapy, protease inhibitors, bone mineral density, osteoporosis, osteopenia, bone mineral loss, fat redistribution, abdominal obesity, metabolic complications, lumbar spine, proximal femur
- MeSH terms
- Aged, Cross-Sectional Studies, Drug Therapy, Combination, Humans, Male, Middle Aged, Osteoporosis, Absorptiometry, Photon, HIV Infections, HIV Protease Inhibitors, Anti-HIV Agents
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