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06.09.2023 | Original Article

Evaluation of bone mineral density, microarchitecture, and detection of fractures on young patients living with human immunodeficiency virus: when and how to screen?

verfasst von: Bárbara Gehrke, Maria Lucia Fleiuss Farias, Luiz Eduardo Wildemberg, Giovanna Ianini Ferraiuoli, Valéria Ribeiro, Rogério Bosgnoli, Francisco de Paula Paranhos Neto, Laura Maria Carvalho de Mendonça, Miguel Madeira, Maria Caroline Alves Coelho

Erschienen in: Endocrine | Ausgabe 1/2024

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Abstract

Purpose

People living with the human immunodeficiency virus (PLWH) developed higher life expectancy along with chronic bone disease over the past years. Our purpose is to evaluate bone mineral density, bone microarchitecture and fractures in young PLWH and understand the disease’s contribution to bone derangements and fracture risk.

Methods

Eighty-one HIV-infected and 54 control young (20–50 years) male and female subjects were enrolled in this study. Methods for patient evaluation included DXA-VFA (dual energy X-rays and vertebral fracture assessment), HR-pQCT (high resolution peripheral quantitative computed tomography), biochemistry and FRAX.

Results

Fifty participants from each group completed all exams. Median age was 40 (25–49) vs. 36.5 (22–50) for the HIV and control groups, respectively (p 0.120). Ethnicity, body mass index, serum phosphorus, 25-hydroxyvitamin D, PTH and CTX were similar between groups, although ALP and OC suggested higher bone turnover in PLWH. VFA identified morphometric vertebral fractures in 12% of PLWH. PLWH had lower values for lumbar spine areal BMD and Z score, volumetric BMD, trabecular bone fraction (BV/TV) and trabecular number measured at the distal tibia by HR-pQCT; as a consequence, trabecular separation and heterogeneity were higher (all p < 0.05). The FRAX-estimated risk for hip and major osteoporotic fractures was statistically higher in PLWH (p < 0.001).

Conclusion

Our results confirm severe bone impairment and fractures associated with HIV in young patients. Thus, we developed a screening protocol for young PLWH to detect bone fragility, reduce skeletal disease progression and morbimortality, decrease fracture risk, and increase quality of life.

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Titel: Evaluation of bone mineral density, microarchitecture, and detection of fractures on young patients living with human immunodeficiency virus: when and how to screen?
verfasst von: Bárbara Gehrke
Maria Lucia Fleiuss Farias
Luiz Eduardo Wildemberg
Giovanna Ianini Ferraiuoli
Valéria Ribeiro
Rogério Bosgnoli
Francisco de Paula Paranhos Neto
Laura Maria Carvalho de Mendonça
Miguel Madeira
Maria Caroline Alves Coelho
Publikationsdatum: 06.09.2023
Verlag: Springer US
Erschienen in: Endocrine / Ausgabe 1/2024
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-023-03501-9

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Evaluation of bone mineral density, microarchitecture, and detection of fractures on young patients living with human immunodeficiency virus: when and how to screen?