Male adolescents and young adults being treated for HIV are more likely to experience low bone mass than are other men their age, according to a study.
The findings suggest that clinicians who care for these patients should monitor them regularly for signs of bone density loss, which could indicate a risk of fractures. The men in the study did not have HIV at birth and had been diagnosed with HIV an average of two years earlier.
Earlier studies showed adults with HIV also have bone loss and increased risk for bone fractures associated in part with the use of certain anti-HIV medications, according to a news release from the National Institutes of Health, which supported the research network that conducted the study.
The 250 study participants, ages 14 to 25, "had been taking anti-HIV medications for a comparatively short time, yet they still had lower bone mineral density than other men their age," said study co-author Bill G. Kapogiannis, MD, of the Pediatric, Adolescent and Maternal AIDS Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
"These findings suggest a short-term impact of HIV therapy on bone at ages when people are still growing and building bone mass. This raises concern about the risk of fracture as they age."
For the HIV-infected young men, on average, bone density was 5% to 8% lower in the hip and 2% to 4% lower in the spine than for study participants without HIV.
About 88% of the study participants identified themselves as African-American or Hispanic and all lived in urban areas. Both bone density and the calcium and other mineral content of bones tended to be lowest in participants taking medication for HIV. Youth with HIV who had not begun treatment had higher bone mass levels than HIV-positive youth who were on anti-HIV regimens, but lower bone mass levels than youth who did not have HIV.
The study was not designed to determine the cause of the bone loss, and the researchers said they cannot rule out the possibility that low bone mass preceded the young men’s HIV infection. They noted that all the young men had several risk factors for bone loss.
Participants’ responses to questions about diet indicated that at least half of them did not consume sufficient calcium or vitamin D, for example. The researchers also found that more than 30% of all the participants smoked. Half said they did not get regular exercise.
The study authors noted that additional studies are needed to follow HIV-positive young men long-term to determine whether bone loss during adolescence increases the risk of fractures later in life.
"None of the young men we saw is in immediate risk of fracture," said Kathleen Mulligan, PhD, of the University of California, San Francisco, and a lead author of the study. "However, our results indicated that it would be a good idea for young men newly diagnosed with HIV to make sure they exercise, get enough calcium and vitamin D, quit smoking and limit alcohol consumption."
The study is scheduled for publication in the journal Clinical Infectious Diseases. To read the abstract and access the study via subscription or purchase, visit http://bit.ly/MhtKj6.
The findings suggest that clinicians who care for these patients should monitor them regularly for signs of bone density loss, which could indicate a risk of fractures. The men in the study did not have HIV at birth and had been diagnosed with HIV an average of two years earlier.
Earlier studies showed adults with HIV also have bone loss and increased risk for bone fractures associated in part with the use of certain anti-HIV medications, according to a news release from the National Institutes of Health, which supported the research network that conducted the study.
The 250 study participants, ages 14 to 25, "had been taking anti-HIV medications for a comparatively short time, yet they still had lower bone mineral density than other men their age," said study co-author Bill G. Kapogiannis, MD, of the Pediatric, Adolescent and Maternal AIDS Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
"These findings suggest a short-term impact of HIV therapy on bone at ages when people are still growing and building bone mass. This raises concern about the risk of fracture as they age."
For the HIV-infected young men, on average, bone density was 5% to 8% lower in the hip and 2% to 4% lower in the spine than for study participants without HIV.
About 88% of the study participants identified themselves as African-American or Hispanic and all lived in urban areas. Both bone density and the calcium and other mineral content of bones tended to be lowest in participants taking medication for HIV. Youth with HIV who had not begun treatment had higher bone mass levels than HIV-positive youth who were on anti-HIV regimens, but lower bone mass levels than youth who did not have HIV.
The study was not designed to determine the cause of the bone loss, and the researchers said they cannot rule out the possibility that low bone mass preceded the young men’s HIV infection. They noted that all the young men had several risk factors for bone loss.
Participants’ responses to questions about diet indicated that at least half of them did not consume sufficient calcium or vitamin D, for example. The researchers also found that more than 30% of all the participants smoked. Half said they did not get regular exercise.
The study authors noted that additional studies are needed to follow HIV-positive young men long-term to determine whether bone loss during adolescence increases the risk of fractures later in life.
"None of the young men we saw is in immediate risk of fracture," said Kathleen Mulligan, PhD, of the University of California, San Francisco, and a lead author of the study. "However, our results indicated that it would be a good idea for young men newly diagnosed with HIV to make sure they exercise, get enough calcium and vitamin D, quit smoking and limit alcohol consumption."
The study is scheduled for publication in the journal Clinical Infectious Diseases. To read the abstract and access the study via subscription or purchase, visit http://bit.ly/MhtKj6.
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