MNL Publimed

HIV-HAART and Bone metabolism:
prevalence of the osteopenia and osteoporosis among the HIV population


ABSTRACT

Since the 1990s many papers have reported on bone metabolism changes even in the pre-HAART era and there has always been a suspicion that the virus was the underlying problem. After the advent of HAART the issue became more complicated because on the one hand HIV-infected patients can live longer but on the other they present the side-effects of treatment and older age. We will review the main studies on bone metabolism in the post Highly Active Antiretroviral Therapy (HAART) era, i.e. since 2003. We can conclude that the prevalence of osteopenia is increased in the HIV positive population (32%-54%); BMD changes are more pronounced in HIV-infected men than in the HIV-negative population.Osteoporosis in men preferentially affects cortical bone. Osteopenia in HIV-infected people is probably multifactorial resulting from diffferent aetiopathogenetic events.In the future we shall need many longitudinal and prospective studies to establish the correlation between BMD, HIV and HAART.
Key words: HIV, Bone metabolism, Prevalence


Articolo presente in  – HAART and correlated pathologies n. 0 – 

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HIV infection and bone changes


ABSTRACT

The introduction of highly active antiretroviral therapy (HAART) has radically changed the natural history of HIV infection. The significant reduction of plasma viremia accompanied by the arrested immune deterioration following administration of new therapeutic protocols between 1996 and 1999 generated cautious optimism also based on mathematical models claiming the possibility of a complete eradication of HIV infection. Even if the advent of HAART has significantly extended the life-span of patients living with AIDS, the increased mean life-span has given rise to long-term complications of HIV such as metabolic complication, cardiovascular disease and osteoporosis. Degenerative processes involving the bone compartment are common during the course of HIV-1 infection. Osteopenia and osteoporosis represent a challenge in clinical and therapeutic management. It has yet to be determined whether the cause of this dysfunction is linked to HIV-1-mediated direct and/or indirect effects on osteoblasts/osteoclasts cross-talk regulation. This report analyzes the numerous factors able to favor bone derangement (bone loss and osteopenia/osteoporosis) in HIV-1 infected patients.
Key words: HIV, HAART, Bone changes


Articolo presente in  – HAART and correlated pathologies n. 0 – 

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Diagnostic assessment of primary and HIV-induced osteoporosis


ABSTRACT

Osteoporosis is a common, often disregarded, disease entailing an increased risk of bone fractures. Bone turnover is the main bone quality parameter, currently measured by biochemical markers, possibly flanked by traditional x-ray investigation. A series of observations on increasingly large cohorts of HIV patients have placed HIV infection among the causes of secondary osteoporosis. It is evident that high bone turnover, as in HIV-induced osteoporosis, involves cancellous bone earlier and to a greater extent, only compromising cortical bone much later. For this reason, BMD measurement in the spine is more likely to disclose osteoporotic disease than tests undertaken in femur. Much progress has been made since the first reports of HIV and HAART-induced bone damage, but we have yet to reach an adequate diagnostic definition.
Key words: HIV, Diagnostic of osteoporosis, Primary osteoporosis, HIV-1 related osteoporosis


Articolo presente in  – HAART and correlated pathologies n. 0 – 

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Evaluation of Bone Mineral Quality by Phalangeal Quantitative Ultrasound in Perinatally HIV-Infected Youths


ABSTRACT

Decreased bone mass density (BMD) is now recognized as an emerging metabolic complication of HIV infection. Several studies have well described the elevated bone turnover in BMD among HIV-infected people. Quantitative ultrasound (QUS) assesses skeletal status by measuring the amplitude-dependent speed of sound (AD-SoS, m/s) and the bone transmission time (BTT, μs). This technique is safe, easy to use, radiation-free and “friendly”, for these characteristics it is particularly indicated among children. The aim of the present study is to evaluate the effects of HIV infection on bone quality by phalangeal QUS in a young population of perinatally HIV-Infected children: 44 patients (23 females, 21 males; aged 3-17 years) were examined and compared with a control population (1227 healty children, 641 males and 586 females; aged 3-16 years). All patients were vertically infected, 7 patients were CDC stage C, 18 B, and 18 A; considering the antiretroviral treatments 4 were naive to any therapy, 7 were taking two NRTIs, and 32 were on HAART. QUS values were significantly lower in cases than in controls, even after adjustment for age and body size. The associations of AD-SoS and BTT with age, skeletal age SDS, height, and therapy duration were statistically significant. Gender, type of therapy, and CDC stages were not associated to AD-SoS and BTT. This article suggests that QUS measurements could be an attractive option for the evaluation of bone quality in HIV-infected children.
Key words: Bone Quality, HIV, Youth


Articolo presente in  – HAART and correlated pathologies n. 0 – 

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