Short-term bone loss in HIV-infected premenopausal women
Yin MT, Lu D, Cremers S, Tien PC, Cohen MH, Shi Q, Shane E, Golub ET, Anastos K.
Low bone mineral density (BMD) has been reported in HIV+ women, but less is known about the longitudinal evolution of BMD and fracture incidence.
In 100 HIV+ and 68 HIV- premenopausal women in the Women’s Interagency HIV Study, BMD was measured by dual energy x-ray absorptiometry at the femoral neck (FN) and lumbar spine (LS) at index visit and after a median of 2.5 years.
In HIV+ women, BMD at index visit was normal but 5% lower at the LS and FN than in HIV- women. Annual percent decrease in BMD did not differ between HIV+ and HIV- women at the LS (-0.8% +/- 0.2% vs -0.4% +/- 0.2%, P = 0.20) or FN (-0.8% +/- 0.3% vs -0.6% +/- 0.3%, P = 0.56) and remained similar after adjustment for age, weight, and BMD at index visit. Among HIV+ women, bone loss was associated with vitamin D deficiency and opiate use but not with use or class of antiretrovirals. Incidence of self-reported fracture was 0.74 per 100 person-years in HIV+ women and similar in HIV- women.
In premenopausal HIV+ women, index BMD was lower than comparable HIV- women; however, rates of bone loss at the LS and FN were similar over 2.5 years of observation, irrespective of antiretroviral therapy.