BONE-MINERAL DENSITY IN PATIENTS WITH HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION

The Object of this study was to determine whether HIV infection is ass ociated with decreased bone mineral density (BMD). BMD was measured by dual-energy X-ray absorptiometry at total body, lumbar spine, and hip in 45 men with HIV infection and compared with sex, age, and weight-m atched controls. Repeat scans were performed after a mean interval of 15 months in 21 patients to determine whether there were detectable lo sses of BMD. Compared with controls, the HIV patients had marginally l ower BMD at the lumbar spine (P = 0.04) but there was no significant d ifference in total body or hip BMD. None of the patients had reduced B MD to levels associated with a diagnosis of osteoporosis. On longitudi nal follow-up, a small decrease in total body BMD (-1.6%; P = 0.02) wa s observed but there was no significant change in spine and hip BMD. I n spite of the many features of HIV infection that might be expected t o cause a reduction in BMD such as cytokine activation, decreased phys ical activity, small bowel disease, hypogonadism, and direct infection of osteogenic cells by HIV, we found only minimal differences in BMD between HIV patients and controls. Furthermore, the HIV patients studi ed did not appear to show excessive loss in bone mineral over time.