Prevalence of and risk factors for low bone mineral density in untreated HIV infection: a substudy of the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial

Objectives HIV infection is associated with a higher prevalence of low bone mineral density (BMD) and fractures than that found in the general population. There are limited data in HIV‐positive adults, naïve to antiretroviral therapy (ART), with which to estimate the relative contribution of untreat...

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Bibliographic Details
Published in:HIV medicine 2015-04, Vol.16 (S1), p.137-146
Main Authors: Carr, A, Grund, B, Neuhaus, J, Schwartz, A, Bernardino, JI, White, D, Badel‐Faesen, S, Avihingsanon, A, Ensrud, K, Hoy, J
Format: Article
Language:English
Subjects:
Absorptiometry, Photon
Adult
antiretroviral therapy
ART‐naïve
Bone Density
bone mineral density
CD4 Lymphocyte Count
Cross-Sectional Studies
Female
Hip - physiology
HIV
HIV Infections - complications
HIV Infections - immunology
HIV Infections - pathology
Humans
Lentivirus
Lumbosacral Region - physiology
Male
Middle Aged
Osteoporosis - diagnosis
Osteoporosis - epidemiology
Prevalence
Risk Factors
Spine - physiology
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Summary:Objectives HIV infection is associated with a higher prevalence of low bone mineral density (BMD) and fractures than that found in the general population. There are limited data in HIV‐positive adults, naïve to antiretroviral therapy (ART), with which to estimate the relative contribution of untreated HIV infection to bone loss. Methods The primary objective of the Strategic Timing of AntiRetroviral Treatment (START) Bone Mineral Density Substudy is to compare the effect of immediate versus deferred initial ART on bone. We evaluated traditional, demographic, HIV‐related and immunological factors for their associations with baseline hip and lumbar spine BMD, measured by dual‐energy X‐ray absorptiometry, using multiple regression. Results A total of 424 ART‐naïve participants were enrolled at 33 sites on six continents; the mean age was 34 years [standard deviation (SD) 10.1 years], 79.0% were nonwhite, 26.0% were women, and 12.5% had a body mass index (BMI) 
ISSN:1464-2662
1468-1293
DOI:10.1111/hiv.12242