Low bone mass in behaviorally HIV-infected young men on antiretroviral therapy: Adolescent Trials Network Study 021B.

TitleLow bone mass in behaviorally HIV-infected young men on antiretroviral therapy: Adolescent Trials Network Study 021B.
Publication TypePublication
Year of Publication2012
AuthorsMulligan K, D Harris R, Emmanuel P, Fielding RA, Worrell C, Kapogiannis BG, Monte D, Sleasman J, Wilson CM, Aldrovandi GM
Corporate AuthorsATN 021 Protocol team
JournalClin Infect Dis
Volume55
Issue3
Pagination461-8
Date Published2012 Aug
ISSN1537-6591
KeywordsAbsorptiometry, Photon, Adolescent, Adult, Anti-Retroviral Agents, Antiretroviral Therapy, Highly Active, Body Composition, Bone Density, Bone Development, Cross-Sectional Studies, HIV Infections, Humans, Male, Young Adult
Abstract

<p><b>BACKGROUND: </b>Peak bone mass is achieved in adolescence/early adulthood and is the key determinant of bone mass in adulthood. We evaluated the association of bone mass with human immunodeficiency virus (HIV) infection and antiretroviral therapy (ART) during this critical period among behaviorally HIV-infected young men and seronegative controls.</p><p><b>METHODS: </b>HIV-positive men (N = 199) and HIV-negative controls (N = 53), ages 14-25 years, were studied at 15 Adolescent Trials Network for HIV/AIDS Interventions sites. HIV-positive participants were recruited on the basis of ART status: ART-naive (N = 105) or on a regimen containing a nonnucleoside reverse transcriptase inhibitor (NNRTI; N = 52) or protease inhibitor (PI; N = 42). Bone mineral density (BMD) and content (BMC) and body composition were measured by dual-energy X-ray absorptiometry (DXA). Results were compared across groups by linear modeling. Bone results were adjusted for race, body mass index (BMI), and type of DXA (Hologic/Lunar).</p><p><b>RESULTS: </b>The HIV-positive and HIV-negative groups had comparable median age (21 years) and racial/ethnic distribution. Median times since HIV diagnosis were 1.3, 1.9, and 2.2 years in the ART-naive, NNRTI, and PI groups, respectively (P = .01). Total and regional fat were significantly lower in the ART-naive group compared with seronegative controls. Mean BMD and Z scores were generally lower among HIV-positive participants on ART, particularly in the PI group. Average Z scores for the spine were below zero in all 4 groups, including controls.</p><p><b>CONCLUSIONS: </b>Young men on ART with a relatively recent diagnosis of HIV infection have lower bone mass than controls. Longitudinal studies are required to determine the impact of impaired accrual or actual loss of bone during adolescence on subsequent fracture risk.</p>

DOI10.1093/cid/cis455
Alternate JournalClin. Infect. Dis.
PubMed ID22573848
PubMed Central IDPMC3491777
Grant ListU01 HD 040533 / HD / NICHD NIH HHS / United States
U01 HD040533 / HD / NICHD NIH HHS / United States
U01 HD 040474 / HD / NICHD NIH HHS / United States
U01 HD040474 / HD / NICHD NIH HHS / United States
U01 HD040497 / HD / NICHD NIH HHS / United States
UL1 RR024131 / RR / NCRR NIH HHS / United States
M01 RR165001 / RR / NCRR NIH HHS / United States
UL1-RR-024134 / RR / NCRR NIH HHS / United States
M01RR020359 / RR / NCRR NIH HHS / United States
UL1 RR024134 / RR / NCRR NIH HHS / United States
M01 RR020359 / RR / NCRR NIH HHS / United States