HIV-positive postmenopausal minority women have high rates of bone loss
MedWire News: Postmenopausal minority women with HIV infection have high rates of bone loss, US research shows.
Investigators report that these women had lower bone mineral density (BMD), increased bone turnover, and higher rates of bone loss, compared with HIV-negative women.
"We found that HIV-positive postmenopausal women had greater annualized rates of bone loss at the lumbar spine and forearm than HIV-negative postmenopausal minority women, regardless of whether they were on antiretroviral therapy [ART]," write Michael Yin (Columbia University Medical Center, New York) and colleagues in the Journal of Clinical Endocrinology and Metabolism.
Upon starting ART, BMD is known to decline between 2% to 6% within the first 2 years. As patients survive longer with ART, HIV-positive men and women develop conditions associated with aging, including osteoporosis. In addition, bone loss might be accelerated in HIV-positive women as they transition into menopause.
In this longitudinal analysis study of 128 postmenopausal Hispanic and African-American women, of whom 73 were HIV positive, the researchers assessed changes in BMD from baseline over a 15-month period. Most HIV-positive women had already taken ART for more than 3 years.
At baseline, BMD, adjusted for age, race, and body mass index (BMI), was significantly lower in the HIV-positive than the HIV-negative women at the lumbar spine, total hip, and radius, and levels of the bone resorption marker serum C-telopeptide were significantly higher.
Among the HIV-positive women, the annualized rate of bone loss at the lumbar spine, adjusted for BMD, was 1.2%, whereas bone loss among HIV-negative women was 0.5%, a 2.4-fold difference.
At the one-third radius, the rate of bone loss was 1.1% in the HIV-positive women compared with a gain of 0.2% for HIV-negative women, a 3.7-fold higher rate of bone loss.
At the distal radius, the annualized rate of bone loss was 1.1% in the HIV-positive women and 0.7% among the HIV-negative women.
"These features may place these women at increased risk for fracture as they age," according to Yin and colleagues.
By MedWire Reporters