Zhang Zaizhu, Lin Qiang, Xu Ying, Guan Wenmin, Song Xiaojing, Li Yanling, Zhang Yi, Li Taisheng, Yu Wei
Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
Department of Radiology, Beijing Arion Cancer Center, Beijing, China.
Arch Osteoporos. 2023 Apr 11;18(1):48. doi: 10.1007/s11657-023-01238-6.
This is the first study to report both greater BMD loss and muscle loss in Chinese HIV-infected males with lamivudine (3TC)-tenofovir disoproxil fumarate (TDF)-efavirenz (EFV) regimen, which highlights the importance of closely monitoring muscle mass and bone mineral density in patients treated with 3TC-TDF-EFV regimen and provides a foundation for the clinical intervention of sarcopenia and osteoporosis.
To compare the effect initiating different antiretroviral therapy (ART) regimens have on muscle mass, bone mineral density (BMD), and trabecular bone score (TBS).
We designed a retrospective study of ART-naive Chinese males with HIV (MWH) undergoing two different regimens at 1-year follow-up. All subjects underwent dual-energy absorptiometry (DXA) for BMD and muscle mass prior to ART initiation, and again 1 year later. TBS iNsight software was used for TBS. We analyzed differences in muscle mass, BMD, and TBS after different treatment arms and associations between ART regimens and changes in them.
A total of 76 men were included (mean age 31.83 ± 8.75 years). Mean absolute muscle mass decreased significantly from baseline to follow-up after initiation of lamivudine (3TC)-tenofovir disoproxil fumarate (TDF)-efavirenz (EFV), whereas increased significantly after initiation of 3TC-zidovudine(AZT)/Stavudine(d4T)-Nevirapine(NVP). Assignment to 3TC-TDF-EFV resulted in greater percentage loss in BMD at lumbar spine (LS) and total hip (TH) compared to 3TC-AZT/d4T-NVP, but this difference was not statistically significant at the femoral neck BMD and TBS. In the multivariable logistic regression model adjusted for covariates, the 3TC-TDF-EFV regimen was associated with higher odds of decreased appendicular and total muscle mass, LS and TH BMD.
This is the first study to report not only greater BMD loss but also muscle loss in Chinese MWH with 3TC-TDF-EFV regimen. Our work highlights the importance of closely monitoring muscle mass and BMD in patients treated with 3TC-TDF-EFV regimen and provides a foundation for the clinical intervention of sarcopenia and osteoporosis in them.
这是第一项报告使用拉米夫定（3TC）-替诺福韦酯（TDF）-依非韦伦（EFV）方案的中国HIV感染男性中骨密度损失和肌肉损失均更大的研究，这突出了在接受3TC-TDF-EFV方案治疗的患者中密切监测肌肉质量和骨矿物质密度的重要性，并为肌肉减少症和骨质疏松症的临床干预提供了基础。
比较启动不同抗逆转录病毒疗法（ART）方案对肌肉质量、骨矿物质密度（BMD）和小梁骨评分（TBS）的影响。
我们设计了一项针对初治HIV感染中国男性（MWH）的回顾性研究，这些男性在1年随访期间接受两种不同方案治疗。所有受试者在开始ART前以及1年后均接受双能吸收法（DXA）检测BMD和肌肉质量。使用TBS iNsight软件进行TBS检测。我们分析了不同治疗组后肌肉质量、BMD和TBS的差异以及ART方案与它们变化之间的关联。
共纳入76名男性（平均年龄31.83±8.75岁）。开始使用拉米夫定（3TC）-替诺福韦酯（TDF）-依非韦伦（EFV）后，从基线到随访期间平均绝对肌肉质量显著下降，而开始使用3TC-齐多夫定（AZT）/司他夫定（d4T）-奈韦拉平（NVP）后则显著增加。与3TC-AZT/d4T-NVP相比，使用3TC-TDF-EFV导致腰椎（LS）和全髋（TH）的BMD损失百分比更大，但在股骨颈BMD和TBS方面，这种差异无统计学意义。在针对协变量进行调整的多变量逻辑回归模型中，3TC-TDF-EFV方案与四肢和总肌肉质量、LS和TH的BMD降低的较高几率相关。
这是第一项报告使用3TC-TDF-EFV方案的中国MWH不仅骨密度损失更大而且肌肉损失也更大的研究。我们的工作突出了在接受3TC-TDF-EFV方案治疗的患者中密切监测肌肉质量和BMD的重要性，并为他们的肌肉减少症和骨质疏松症的临床干预提供了基础。
