Background Patients with human immunodeficiency virus (HIV) have a higher prevalence of low bone mineral density (BMD) and fractures than the general population, but there are no comparative studies in Spanish population.
Objectives To assess the BMD in HIV-infected patients followed in a tertiary hospital of Madrid and compare it with the ESOSVAL cohort, which included 11035 patients and is representative of non-HIV population seen in Spanish tertiary centers.
Methods We performed a cross-sectional study in which BMD values were determined in a prospective cohort that included HIV-infected patients seen our center during the period 2010–2015. Collected data included demography, comorbidities, treatment and densitometric variables.
Results 93 patients from a total of a total of 924 with BMD data were eligible for the study after discarding those younger than 55 years, because that group is not included in the ESOSVAL cohort. Mean age of patients of our whole cohort was 43.8 years (range: 17–83), 11% were older than 55 years, of whom 83 were men (83%). Most of them were Caucasians, with a mean body mass index 24.1 (range: 14,7–40.6). Median time of HIV infection was 162,6 months (interquartile range [IQR]: 77.7- 283,3), median CD4+ cells nadir was 224 (IQR: 100–332) and median maximun viral load was 4,9 log (IQR: 4,3–5,4); concomitant hepatitis C virus infection was present in 29%. 25% were treated with tenofovir plus protease inhibitors, and 47% with tenofovir plus a non-nucleoside reverse transcriptase inhibitor. The mean value of BMD in lumbar spine (LS) was 0.93 g/cm2 (range: 0.84–1.02) and in femoral neck (FN) 0.78 g/cm2 (range: 0.69–0.86). For the comparison with the ESOSVAL cohort the worst value of T-score in either LS or FN was chosen and patients were classified according to WHO definitions (osteoporosis ≤ -2.5, osteopenia -1 to -2.5); the results are presented in the table. Only the data for the 50–64 and 65–74 years groups were compared because the number of older HIV patients in our center was small. Significant differences were found between the categories of osteoporosis in men in the 65–74 years old group, and that of osteopenia in women in the 55–64 years old group.
Conclusions We observed a statistically significant increase in prevalence of osteoporosis in HIV-infected men in the 65–74 years group, and in osteopenia HIV-infected men in the 55–64 years group, in concordance with the presumed greater risk derived from a variety of causes (treatment, chronic inflammatory status, comorbidities, etc.). A non significant trend towards an increased prevalence of osteoporosis in the 55–64 years group, and in osteopenia in the 65–74 years group was seen. As for women, there was a statistically significant increase in osteopenia prevalence in the 55–64 years group with HIV and a non significant trend towards increased prevalence of osteoporosis in that age group, whereas no significant increase was observed in the 65–74 years HIV group, presumably due to the small number of patients included in it.
Disclosure of Interest None declared