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Bone mineral density often low in women infected with HIV
  By Will Boggs, MD
NEW YORK (Reuters Health) - Women infected with HIV have abnormally low bone mineral density (BMD) at several sites, according to a report in the August issue of The Journal of Clinical Endocrinology & Metabolism.
"Bone loss is significant, even in young, premenopausal HIV-infected women," Dr. Steven Grinspoon told Reuters Health. "The bone loss relates largely to traditional risk factors, including low weight and relatively high bone turnover."
Dr. Grinspoon from Harvard Medical School, Boston, Massachusetts and colleagues investigated bone mineral density and changes in bone density over 2 years of follow-up in 100 HIV-infected females and 100 healthy controls similar in age and race.
At baseline, HIV-infected women had significantly lower BMD at the lumbar spine, hip, and femoral neck than did the control women, the team reports.
Forty-one percent of the HIV-infected women had osteopenia, the results indicate, and 7% had osteoporosis.
Osteocalcin and urine N-telopeptide of type 1 collagen (NTx) levels were significantly higher in HIV-infected women, the researchers note.
All differences persisted at the 2-year follow-up, the report indicates, but the rates of change in BMD did not differ between HIV-infected women and healthy controls. The stability in BMD over time argues against ongoing active bone loss in HIV-infected women relative to the controls, the investigators say. "Further studies are needed to determine the mechanisms and treatment strategies for bone loss in HIV-infected women," Dr. Grinspoon said. "HIV-infected women with risk factors for bone loss, including low weight, and history of severe weight loss, increased bone turnover, and low vitamin D, should be screened for bone loss with DEXA scanning."
"We are studying the relationship of testosterone deficiency to bone loss in HIV-infected women and the potential use of testosterone replacement among low weight HIV-infected patients with bone loss and low androgen levels," Dr. Grinspoon added.
J Clin Endocrinol Metab 2006;91:2938-2945.
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