Prevalence and risk factors of low bone mineral density in Korean HIV-infected patients: impact of abacavir and zidovudine

J Korean Med Sci. 2013 Jun;28(6):827-32. doi: 10.3346/jkms.2013.28.6.827. Epub 2013 Jun 3.

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 ≥ 1 yr; however, it was more prevalent in patients on the zidovudine-based regimen for ≥ 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.

Keywords: Abacavir; Acquired Immunodeficiency Syndrome; Bone Density; HIV; Zidovudine.

MeSH terms

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

Substances

  • Anti-HIV Agents
  • Dideoxynucleosides
  • Zidovudine
  • abacavir