Bruera Dario, Luna Norma, David Daniel O, Bergoglio Liliana M, Zamudio Javier
Endocrinology Department, Hospital Nacional de Clínicas, Medical Science School, National University of Cordoba, Cordoba, Argentina.
AIDS. 2003 Sep 5;17(13):1917-23. doi: 10.1097/00002030-200309050-00010.
To describe the alterations in the bone metabolism of HIV-seropositive patients and evaluate the effects of antiretroviral therapies.
Cross-sectional analytical study.
A total of 142 subjects (113 male, 29 female), aged 20-45 years were divided into four groups: group A, 33 HIV-seropositive antiretroviral-naive patients; group B1, 36 HIV-seropositive patients on antiviral therapy for over 1 year, without protease inhibitors (PI); group B2, 42 HIV-seropositive patients on combined therapy containing PI for over 1 year; and group C, 15 healthy, HIV-seronegative subjects. Bone mineral density (BMD) were determined by dual energy X-ray absorptiometry in total body, lumbar spine and proximal femur; and evaluation of serum osteocalcin, d-pyridinoline, parathyroid hormone (THP), calcium and phosphate, and urine calcium.
BMD was significantly lower in HIV-seropositive patients in comparison with healthy controls, in all sites studied. However, no statistical differences were observed among all groups of HIV-infected patients, independently of the antiretroviral therapy. There was a significantly higher occurrence of osteopenia and osteoporosis in HIV-infected patients in comparison with controls (P < 0.0001), with no differences among treatment-naive patients and either of the treatment groups. Bone formation and resorption markers were similar among all studied groups. There was a significant correlation in all bone sites between time of infection and BMD (P < 0.02).
BMD was significantly lower in HIV-seropositive patients in comparison with controls in lumbar spine, proximal femur and total body, without significant differences among treatment-naive patients and either of the treatment groups. Only time with HIV infection and not specific therapy was associated with BMD decreases.
描述HIV血清阳性患者骨代谢的改变，并评估抗逆转录病毒疗法的效果。
横断面分析研究。
总共142名年龄在20至45岁之间的受试者（113名男性，29名女性）被分为四组：A组，33名未接受过抗逆转录病毒治疗的HIV血清阳性患者；B1组，36名接受抗病毒治疗超过1年且未使用蛋白酶抑制剂（PI）的HIV血清阳性患者；B2组，42名接受含PI联合治疗超过1年的HIV血清阳性患者；C组，15名健康的HIV血清阴性受试者。采用双能X线吸收法测定全身、腰椎和股骨近端的骨密度；并评估血清骨钙素、d-吡啶啉、甲状旁腺激素（THP）、钙和磷以及尿钙。
在所有研究部位，HIV血清阳性患者的骨密度均显著低于健康对照组。然而,在所有HIV感染患者组中未观察到统计学差异，无论抗逆转录病毒治疗情况如何。与对照组相比，HIV感染患者中骨量减少和骨质疏松的发生率显著更高（P < 0.0001），未接受治疗的患者与任何一个治疗组之间无差异。所有研究组之间的骨形成和骨吸收标志物相似。在所有骨部位，感染时间与骨密度之间存在显著相关性（P < 0.02）。
与对照组相比，HIV血清阳性患者腰椎、股骨近端和全身的骨密度显著降低，未接受治疗的患者与任何一个治疗组之间无显著差异。与骨密度降低相关的仅为HIV感染时间，而非特定治疗。
