Mechanisms of bone disease in HIV and hepatitis C virus: impact of bone turnover, tenofovir exposure, sex steroids and severity of liver disease

Roger Bedimo, James Cutrell, Song Zhang, Henning Drechsler, Ang Gao, Geri Brown, Irfan Farukhi, Rosinda Castanon, Pablo Tebas, Naim M. Maalouf

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

OBJECTIVE:: Both HIV and hepatitis C virus (HCV) infections are associated with higher osteoporotic fracture risk. Increased bone turnover, liver fibrosis, tenofovir (TDF) use or hormonal imbalances are possible underlying mechanisms. DESIGN:: This prospective, cross-sectional study assessed 298 male volunteers with either virologically suppressed HIV or untreated HCV mono-infections, HIV/HCV co-infection and noninfected controls. METHODOLOGY:: Study participants underwent bone mineral density (BMD) by dual-energy x-ray absorptiometry and measurement of bone turnover markers [BTM: C-telopeptide (CTX) and osteocalcin (OC)], insulin-like growth factor-1 (IGF-1), the sex steroids testosterone (T) and estradiol (E2), and the aspartate aminotransferase-to-platelet ratio index (APRI). Impact of HIV and HCV status on BMD was evaluated in multivariate models adjusting for APRI score, BTM, TDF exposure, IGF-1, and sex steroids. RESULTS:: HIV and HCV status independently predicted lower BMD, controlling for age, race, BMI, and smoking (P?=?0.017 and P?=?0.010 respectively), whereas APRI did not (P?=?0.84). HIV was associated with increased bone resorption (CTX: P?

Original languageEnglish (US)
JournalAIDS
DOIs
StateAccepted/In press - Nov 10 2015

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

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