Changes in trabecular bone score and bone mineral density in Chinese HIV-Infected individuals after one year of antiretroviral therapy
Objective: Human immunodeficiency virus (HIV) infection and antiretroviral therapy (ART) have been associated with reduced bone mineral density (BMD) in persons with HIV (PWH). BMD provides information only about bone mineral quantity. Trabecular bone score (TBS) is a noninvasive tool that estimates...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-07-01
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| Series: | Journal of Orthopaedic Translation |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214031X21000243 |
| _version_ | 1818881327232974848 |
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| author | Wen-Min Guan Wei Pan Wei Yu Wei Cao Qiang Lin Zai-Zhu Zhang Xiao-Jing Song Yan-Ling Li Jun-Ping Tian Ying Xu Tai-Sheng Li Evelyn Hsieh |
| author_facet | Wen-Min Guan Wei Pan Wei Yu Wei Cao Qiang Lin Zai-Zhu Zhang Xiao-Jing Song Yan-Ling Li Jun-Ping Tian Ying Xu Tai-Sheng Li Evelyn Hsieh |
| author_sort | Wen-Min Guan |
| collection | DOAJ |
| description | Objective: Human immunodeficiency virus (HIV) infection and antiretroviral therapy (ART) have been associated with reduced bone mineral density (BMD) in persons with HIV (PWH). BMD provides information only about bone mineral quantity. Trabecular bone score (TBS) is a noninvasive tool that estimates bone microarchitecture. The aim of this study is to measure BMD and TBS of Chinese PWH after one-year ART. Methods: We designed a retrospective study of adult Chinese PWH. Patients with a dual-energy X-ray absorptiometry (DXA) scan prior to ART initiation, and again 48 weeks later were included. Information regarding demographic and clinical history, HIV treatment history, BMD and TBS were collected. We analyzed differences in BMD and TBS over 48 weeks and associations between key risk factors and changes in BMD and TBS. Results: Our study included 233 PWH (mean age = 36.6 ± 11.1 years). Before ART initiation, 19.3% of PWH had normal BMD but abnormal TBS. Both BMD and TBS decreased after one-year ART. TDF and LPV/r-containing regimens were associated with greater declines in BMD at different site. Traditional risk factors such as old age, low BMI and female sex were associated with lower baseline TBS. Greater change in TBS over one year was associated with lower BMI and lower baseline CD4+ cell count, but unlike BMD measures, it was not correlated with treatment with TDF and LPV/r in our study population. Conclusions: We present the first longitudinal analysis of change in TBS over 48 weeks compared with BMD among Asian PWH receiving ART. Before ART initiation, approximately 20% of PWH with impaired bone microarchitecture would not have been identified if DXA were used alone to assess for bone damage. Both BMD and TBS decreased after one-year ART. Change in TBS was not associated with different antiretroviral agents. The translational potential of this article: The trabecular microarchitecture measured indirectly by TBS may provide clinicians additional information about bone damage in PWH. |
| first_indexed | 2024-12-19T15:00:06Z |
| format | Article |
| id | doaj.art-4b6e432055724e57865dda5919d64f7d |
| institution | Directory Open Access Journal |
| issn | 2214-031X |
| language | English |
| last_indexed | 2024-12-19T15:00:06Z |
| publishDate | 2021-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Orthopaedic Translation |
| spelling | doaj.art-4b6e432055724e57865dda5919d64f7d2022-12-21T20:16:36ZengElsevierJournal of Orthopaedic Translation2214-031X2021-07-01297277Changes in trabecular bone score and bone mineral density in Chinese HIV-Infected individuals after one year of antiretroviral therapyWen-Min Guan0Wei Pan1Wei Yu2Wei Cao3Qiang Lin4Zai-Zhu Zhang5Xiao-Jing Song6Yan-Ling Li7Jun-Ping Tian8Ying Xu9Tai-Sheng Li10Evelyn Hsieh11Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medicine Sciences and Peking Union Medical College, Beijing. 100730, ChinaDepartment of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medicine Sciences and Peking Union Medical College, Beijing, 100730, ChinaDepartment of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medicine Sciences and Peking Union Medical College, Beijing. 100730, China; Corresponding author. 1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China.Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medicine Sciences and Peking Union Medical College, Beijing, 100730, ChinaDepartment of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medicine Sciences and Peking Union Medical College, Beijing. 100730, ChinaDepartment of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medicine Sciences and Peking Union Medical College, Beijing. 100730, ChinaDepartment of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medicine Sciences and Peking Union Medical College, Beijing, 100730, ChinaDepartment of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medicine Sciences and Peking Union Medical College, Beijing, 100730, ChinaDepartment of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medicine Sciences and Peking Union Medical College, Beijing. 100730, ChinaDepartment of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medicine Sciences and Peking Union Medical College, Beijing. 100730, ChinaDepartment of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medicine Sciences and Peking Union Medical College, Beijing, 100730, China; Tsinghua University Medical College, Beijing, 100084, China; Corresponding author. 1 Shuaifuyuan Street, Dongcheng District, Beijing, 100730, China.Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medicine Sciences and Peking Union Medical College, Beijing, 100730, China; Section of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, 06511, USAObjective: Human immunodeficiency virus (HIV) infection and antiretroviral therapy (ART) have been associated with reduced bone mineral density (BMD) in persons with HIV (PWH). BMD provides information only about bone mineral quantity. Trabecular bone score (TBS) is a noninvasive tool that estimates bone microarchitecture. The aim of this study is to measure BMD and TBS of Chinese PWH after one-year ART. Methods: We designed a retrospective study of adult Chinese PWH. Patients with a dual-energy X-ray absorptiometry (DXA) scan prior to ART initiation, and again 48 weeks later were included. Information regarding demographic and clinical history, HIV treatment history, BMD and TBS were collected. We analyzed differences in BMD and TBS over 48 weeks and associations between key risk factors and changes in BMD and TBS. Results: Our study included 233 PWH (mean age = 36.6 ± 11.1 years). Before ART initiation, 19.3% of PWH had normal BMD but abnormal TBS. Both BMD and TBS decreased after one-year ART. TDF and LPV/r-containing regimens were associated with greater declines in BMD at different site. Traditional risk factors such as old age, low BMI and female sex were associated with lower baseline TBS. Greater change in TBS over one year was associated with lower BMI and lower baseline CD4+ cell count, but unlike BMD measures, it was not correlated with treatment with TDF and LPV/r in our study population. Conclusions: We present the first longitudinal analysis of change in TBS over 48 weeks compared with BMD among Asian PWH receiving ART. Before ART initiation, approximately 20% of PWH with impaired bone microarchitecture would not have been identified if DXA were used alone to assess for bone damage. Both BMD and TBS decreased after one-year ART. Change in TBS was not associated with different antiretroviral agents. The translational potential of this article: The trabecular microarchitecture measured indirectly by TBS may provide clinicians additional information about bone damage in PWH.http://www.sciencedirect.com/science/article/pii/S2214031X21000243Human immunodeficiency virus (HIV)Antiretroviral therapy (ART)Bone mineral density (BMD)Trabecular bone score (TBS)Tenofovir disoproxil fumarate (TDF) |
| spellingShingle | Wen-Min Guan Wei Pan Wei Yu Wei Cao Qiang Lin Zai-Zhu Zhang Xiao-Jing Song Yan-Ling Li Jun-Ping Tian Ying Xu Tai-Sheng Li Evelyn Hsieh Changes in trabecular bone score and bone mineral density in Chinese HIV-Infected individuals after one year of antiretroviral therapy Journal of Orthopaedic Translation Human immunodeficiency virus (HIV) Antiretroviral therapy (ART) Bone mineral density (BMD) Trabecular bone score (TBS) Tenofovir disoproxil fumarate (TDF) |
| title | Changes in trabecular bone score and bone mineral density in Chinese HIV-Infected individuals after one year of antiretroviral therapy |
| title_full | Changes in trabecular bone score and bone mineral density in Chinese HIV-Infected individuals after one year of antiretroviral therapy |
| title_fullStr | Changes in trabecular bone score and bone mineral density in Chinese HIV-Infected individuals after one year of antiretroviral therapy |
| title_full_unstemmed | Changes in trabecular bone score and bone mineral density in Chinese HIV-Infected individuals after one year of antiretroviral therapy |
| title_short | Changes in trabecular bone score and bone mineral density in Chinese HIV-Infected individuals after one year of antiretroviral therapy |
| title_sort | changes in trabecular bone score and bone mineral density in chinese hiv infected individuals after one year of antiretroviral therapy |
| topic | Human immunodeficiency virus (HIV) Antiretroviral therapy (ART) Bone mineral density (BMD) Trabecular bone score (TBS) Tenofovir disoproxil fumarate (TDF) |
| url | http://www.sciencedirect.com/science/article/pii/S2214031X21000243 |
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