Deficits in bone strength, density and microarchitecture in women living with HIV: A cross-sectional HR-pQCT study
Heather M. Macdonald, Evelyn J Maan, Claudie Berger
Hélène C F Côté, Melanie C M Murray, Neora Pick, Jerilynn C Prior, Rachel A. Dunn
Author affiliations (6)
Department of Family Practice, Faculty of Medicine, University of British Columbia, 5950 University Blvd, Vancouver, British Columbia V6T 1Z3, Canada; Centre for Hip Health and Mobility, Vancouver ...
Women's Health Research Institute, H214-4500 Oak St, Vancouver, British Columbia V6H 3N1, Canada; Department of Pathology & Laboratory Medicine, University of British Columbia, Rm. G227 - 2211 Wesb...ROR
With the advent of combined antiretroviral therapy (cART), life expectancy has increased among persons living with HIV, but so too has risk for comorbidities including osteoporosis and fragility fracture. To explore whether HIV status and cART influence three-dimensional measures of BMD, bone microarchitecture and strength we aimed to compare these outcomes between women living with HIV (WLWH; n = 50; 50.4 ± 1.2 years, 44% postmenopausal) and without HIV (controls; n = 50; 51.8 ± 1.2 years, 52% postmenopausal).
Methods
Outcomes were lumbar spine, total hip and femoral neck areal BMD by DXA; distal radius and tibia trabecular BMD, thickness and number, and cortical BMD and area by HR-pQCT; and finite element analysis-derived bone strength (failure load). Multivariable regression analysis compared bone outcomes between groups adjusting for known osteoporosis risk factors. Within WLWH, we examined associations between bone outcomes and HIV-related factors including disease severity and cART duration.
Results
WLWH were diagnosed 20 ± 4 years ago, were on cART for 123 ± 37 months and 80% had HIV plasma viral load <40 copies/mL. For women ≥50 years (n = 61), total hip aBMD T-Score was lower among WLWH than controls. Adjusted distal radius trabecular BMD and thickness and distal tibia trabecular BMD and failure load were 8-19% lower in WLWH than controls (p < 0.05). Cortical BMD and area did not differ between groups at either site. Lifetime cART duration and current plasma viral load were not associated with bone outcomes in WLWH; however, previous treatment with tenofovir was negatively associated with distal radius trabecular BMD and trabecular number and LS aBMD T-score.
Conclusions
WLWH have compromised BMD, bone microarchitecture and strength vs. controls of similar age and reproductive status. Treatment with tenofovir may contribute to bone deficits in WLWH.
HIV women bone mineral density microarchitecture HR-pQCT, Prior JC bone density HIV antiretroviral therapy, tenofovir bone loss trabecular BMD women, HR-pQCT finite element analysis bone strength HIV, antiretroviral therapy osteoporosis risk women cross-sectional study, HIV postmenopausal women bone microarchitecture deficits, cortical trabecular bone differences women living with HIV, menstrual cycle reproductive status bone density HIV, cART duration bone outcomes distal radius tibia, DXA lumbar spine hip BMD HIV women
PMID 32599222 32599222 DOI 10.1016/j.bone.2020.115509 10.1016/j.bone.2020.115509
Cite this article
Heather M Macdonald, Evelyn J Maan, Claudie Berger, Rachel A Dunn, Hélène C F Côté, Melanie C M Murray, Neora Pick, & Jerilynn C Prior (2020). Deficits in bone strength, density and microarchitecture in women living with HIV: A cross-sectional HR-pQCT study. Bone, 138, 115509. https://doi.org/10.1016/j.bone.2020.115509
Heather M Macdonald, Evelyn J Maan, Claudie Berger, Rachel A Dunn, Hélène C F Côté, Melanie C M Murray, et al. Deficits in bone strength, density and microarchitecture in women living with HIV: A cross-sectional HR-pQCT study. Bone. 2020;138:115509. doi:10.1016/j.bone.2020.115509
Heather M Macdonald, et al. "Deficits in bone strength, density and microarchitecture in women living with HIV: A cross-sectional HR-pQCT study." Bone, vol. 138, 2020, pp. 115509.
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Bone HealthFamily History and GeneticsMeta-AnalysisProspective Cohort Studies
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