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Vitamin D and Bone Mineral Density in HIV Newly Diagnosed Therapy-Naive Patients Without Any Secondary Causes of Osteoporosis

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Abstract

Bone loss and vitamin D deficiency are common in HIV patients. However, bone health status in newly diagnosed HIV patients has not been thoroughly described. Our aim was to assess the bone mineral density (BMD), bone resorption and vitamin D status in newly diagnosed HIV patients. A prospective observational study in HIV newly diagnosed therapy-naive persons. Patients with secondary causes of osteoporosis were excluded. Bone densitometry (DXA), a bone resorption marker (CTx), 25-hydroxyvitamin D (25OHD), CD4 count and HIV viral load (VL) were done in 70 patients. Vitamin D results were compared with a group of healthy volunteers. All patients were men, mean age 31 years (19–50). Low BMD (Z score ≤ 2.0) was found in 13%, all of them in lumbar spine, and in only one patient also in femoral neck. Bone resorption was high in 16%. One out of four participants had low BMD or high bone resorption. Vitamin D deficiency (25OHD < 20 ng/mL) was found in 66%. Mean 25OHD in patients was significantly lower than in healthy volunteers (p = 0.04). No associations were found between BMD, CTx, 25OHD and VL or CD4 count. We hypothesize that HIV infection negatively affects bone health based on the results we found among newly diagnosed, therapy-naive, HIV-infected patients, without any known secondary causes of osteoporosis. Low BMD or high bone resorption, are significantly prevalent in these patients. HIV-infected patients had a higher prevalence of vitamin D deficiency than controls, which was not correlated with CD4 count or VL.

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Acknowledgements

The authors thank Erin Hamilton MPH., for her contribution in editing and the critical review of this manuscript. “Laboratorio de Infectología y Virología Molecular” of Pontificia Universidad Católica de Chile for helping in the storage of samples. Industry sponsor MSD (Merck Sharp & Dohme) provided funding for biochemical and DXA assays. No funding was given to the authors. The industry had no role in the design and conduct of the study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Department of Infectious Diseases, Faculty of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile

    María Elena Ceballos & Camila Carvajal

  2. Department of Endocrinology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile

    Javier Jaramillo & Gilberto González

  3. Department of Public Health, Faculty of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile

    Angelica Dominguez

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  1. María Elena Ceballos
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Contributions

MEC originally designed, conducted the study and prepared the first draft of the paper. CC contributed to the experimental work. JJ and AD were responsible for statistical analysis of the data. GG helped in the design of the study and made corrections to the paper. He is the guarantor. All authors revised the paper critically for intellectual content and approved the final version. All authors agree to be accountable for the work and to ensure that any questions relating to the accuracy and integrity of the paper are investigated and properly resolved.

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Correspondence to Gilberto González.

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Conflict of interest

María Elena Ceballos, Camila Carvajal, Javier Jaramillo, Angelica Dominguez, and Gilberto González declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in this study were in accordance with the standards of Ethics Review Committee of the School of Medicine of our institution (Pontificia Universidad Católica de Chile) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Ceballos, M.E., Carvajal, C., Jaramillo, J. et al. Vitamin D and Bone Mineral Density in HIV Newly Diagnosed Therapy-Naive Patients Without Any Secondary Causes of Osteoporosis. Calcif Tissue Int 104, 42–49 (2019). https://doi.org/10.1007/s00223-018-0474-5

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  • DOI: https://doi.org/10.1007/s00223-018-0474-5

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