Risk factors of osteopenia in HIV-infected women: no role of antiretroviral therapy.

OBJECTIVES: Osteopenia and osteoporosis are more frequent in HIV-infected patients. Whether antiretroviral therapy induces a bone mineral density (BMD) loss remains controversial and few data are available in women. This cross-sectional study of 89 pre-menopausal HIV-infected women evaluates the relationship between BMD and antiretroviral treatment.

METHODS: Three groups of women were compared: women never treated (n=37), women treated with nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors and never treated with protease inhibitor (PI) (n=25) and women treated with a PI-containing regimen (n=27). Their lumbar spine and hip BMD was measured by dual-energy X-ray absorptiometry. We assessed also demographic parameters, body mass index (BMI), habits, history of HIV infection and treatment, lipodystrophy and metabolic and hormonal parameters.

RESULTS: 83% were African women. Mean age was 37 years. Median duration of HIV treatment was 3.5 years. The overall prevalence of osteopenia/porosis was 31.5%. No difference was found between the three groups. Using logistic regression, low BMI was the only factor associated with osteopenia/porosis.

CONCLUSION: Osteopenia/porosis was highly prevalent among these HIV-infected pre-menopausal women, mainly of African origin. BMD loss was not associated with antiretroviral therapy (containing PI or not) but was associated with a low BMI.