Center for Infectious Diseases, Department of Internal Medicine, National Medical Center, Seoul, Korea.
J Korean Med Sci. 2013 Jun;28(6):827-32. doi: 10.3346/jkms.2013.28.6.827. Epub 2013 Jun 3.
Low bone mineral density (BMD) is common in HIV-infected patients. We aimed to describe the prevalence of low BMD and risk factors in Korean HIV-infected patients and to assess the effects of antiretroviral therapy (ART) on BMD. We retrospectively evaluated 224 HIV infected-patients. The prevalence of osteopenia and osteoporosis were 41.5% and 12.9%. These were much higher in 53 patients aged 50 yr and older (52.8% and 34.0%). Older age, lower body mass index, and ART > 3 months were independent risk factors for low BMD. Osteoporosis was more prevalent in patients on the abacavir-based regimen for < 1 yr than ≥ 1 yr; however, it was more prevalent in patients on the zidovudine-based regimen for ≥ 1 yr than < 1 yr (P = 0.017). Osteoporosis in patients on the abacavir-based regimen was more common in the spine than in the femur (P = 0.01). Given such a high prevalence of low BMD, close monitoring of BMD for HIV-infected patients on ART is required. The different prevalence of osteoporosis over time and affected areas between two regimens suggest they may play roles in different mechanisms in bone loss.
HIV 感染者普遍存在低骨密度（BMD）。本研究旨在描述韩国 HIV 感染者低 BMD 的流行情况和危险因素，并评估抗逆转录病毒疗法（ART）对 BMD 的影响。我们回顾性评估了 224 例 HIV 感染患者。骨量减少和骨质疏松症的患病率分别为 41.5%和 12.9%。50 岁及以上的 53 名患者中，这两种情况的患病率更高（分别为 52.8%和 34.0%）。年龄较大、体重指数较低以及接受 ART > 3 个月是低 BMD 的独立危险因素。在接受阿巴卡韦为基础方案治疗 < 1 年的患者中，骨质疏松症比接受治疗≥1 年的患者更常见；但在接受齐多夫定为基础方案治疗≥1 年的患者中，骨质疏松症比接受治疗< 1 年的患者更常见（P = 0.017）。在接受阿巴卡韦为基础方案治疗的患者中，骨质疏松症在脊柱比在股骨中更常见（P = 0.01）。鉴于低 BMD 的高患病率，需要对接受 ART 的 HIV 感染者的 BMD 进行密切监测。两种方案之间不同时间和不同部位的骨质疏松症的患病率表明，它们可能在骨质流失的不同机制中发挥作用。
