*INSERM Unité 897, Université Bordeaux Segalen, Bordeaux, France; †Institut de Santé Publique, Epidémiologie et Développement (ISPED), Université Bordeaux Segalen, Bordeaux, France; ‡COREVIH d'Aquitaine, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France; §Services des Maladies Infectieuses et Médecine Tropicale, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France; ‖Service d'Imagerie Médicale, CHU de Bordeaux, Bordeaux, France; ¶Service de Rhumatologie, CHU de Bordeaux, Bordeaux, France; and #Service de Médecine Interne et de Maladies Infectieuses, Hôpital Saint André, CHU de Bordeaux, Bordeaux, France. **See the Appendix for details.
J Acquir Immune Defic Syndr. 2013 Apr 1;62(4):430-5. doi: 10.1097/QAI.0b013e3182845d88.
High prevalence rates of low bone mineral density (BMD) have been reported in people living with HIV infection. We aimed to investigate the association of chronic viral hepatitis with low BMD in HIV-infected patients.
A hospital-based cohort of HIV-infected patients was screened for hepatitis B and C coinfection. BMD was measured by dual energy x-ray absorptiometry. T-score was used to define bone status according to the World Health Organization's classification; moreover, each observed BMD value was compared with reference to an average person of the same age and gender as a Z-score <-2.0 allow the diagnosis of patients having less bone mass and/or losing bone material more rapidly than expected. A polytomial logistic regression was performed by gender to investigate the association between chronic viral hepatitis and low BMD (osteopenia and osteoporosis) in HIV-infected patients.
A total of 626 patients (166 females of whom 52 postmenopausal) were recruited: 357 HIV monoinfected, and 269 HIV-coinfected with chronic viral hepatitis, among whom 61 with a diagnosis of cirrhosis. Osteopenia was present in 320 patients (51.1%) and osteoporosis in 187 (29.9%). After adjustment, osteoporosis was associated with older age and low body mass index in both genders. The association between chronic viral hepatitis B or C and osteoporosis was found in women only (odds ratio: 19.0; P value: 0.047).
We found a high prevalence of low BMD overall, but chronic viral hepatitis was independently associated with osteoporosis only in female participants. Our data confirm the need of BMD evaluations for patients living with HIV.
感染 HIV 的人群中，低骨密度（BMD）的发生率较高。我们旨在研究慢性病毒性肝炎与 HIV 感染患者低 BMD 的关系。
对 HIV 感染患者进行了一项基于医院的慢性乙型肝炎和丙型肝炎合并感染筛查。采用双能 X 线吸收法测量 BMD。T 评分根据世界卫生组织的分类定义了骨状态；此外，每个观察到的 BMD 值与同年龄和性别的平均人的 BMD 值进行了比较，Z 值<-2.0 允许诊断出骨质减少和/或骨质丢失速度快于预期的患者。我们按性别进行了多元逻辑回归，以研究慢性病毒性肝炎与 HIV 感染患者低 BMD（骨质疏松症和骨质疏松症）之间的关系。
共纳入 626 例患者（166 例女性，其中 52 例绝经后）：357 例 HIV 单感染，269 例 HIV 合并慢性病毒性肝炎，其中 61 例诊断为肝硬化。320 例患者（51.1%）存在骨质疏松症，187 例（29.9%）存在骨质疏松症。调整后，两性中骨质疏松症与年龄较大和低体重指数相关。在女性中发现慢性乙型肝炎或丙型肝炎与骨质疏松症有关（比值比：19.0；P 值：0.047）。
我们发现总体上 BMD 水平较低，但仅在女性参与者中，慢性病毒性肝炎与骨质疏松症独立相关。我们的数据证实了对 HIV 感染者进行 BMD 评估的必要性。
