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Background and objectives

Prevalence and Associated Factors of Low Bone Mineral Density in a Large Cohort of HIV Infected Patients. A. Bonjoch 1 , M. Figueras 2 , J. Puig 1 , C. Estany 1 , N. Pérez-Álvarez 2 , B. Clotet 3 , E. Negredo 1

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Background and objectives

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  1. Prevalence and Associated Factors of Low Bone Mineral Density in a Large Cohort of HIV Infected Patients. A. Bonjoch1, M. Figueras2, J. Puig1, C. Estany1, N. Pérez-Álvarez2, B. Clotet3, E. Negredo1 1Lluita contra la SIDA Foundation, University Hospital Germans Trias, Barcelona, Spain, Badalona, Spain, 2Statistics and Operations Research, Technical University of Catalunya, Barcelona, Spain, 3Lluita contra la SIDA Foundation, Germans Trias University Hospital and IrsiCaixa Foundation, Badalona, Spain

  2. Background and objectives Bone demineralization and bone fractures are an emergent problem in HIV-1 infected patients with a multifactorial mechanism. This increased risk raises the necessity of identifying the predisposing factors in order to provide strategies of treatment and prevention approaches. OBJECTIVES • To determine the prevalence of bone demineralization in our cohort of patients. • To identify factors associated with BMD loss.

  3. Design All patients visited in our Unit (2,300 pts) with ≥1 DXA performed from 2000 to 2009 Cross-sectional study N= 671 Longitudinal study (≥2 DXA) N= 391 Data collected: Age, ethnicity, gender, smoke and physical exercise, comorbidities, concomitant medication. Time with HIV-1 infection, time on antiretroviral therapy, time with suppressed viral load, current and previous antiretroviral regimens, current CD4+ T-cell count, HIV-1 viral load, nadir CD4+ count and peak viral load. Statistical analyses:to investigate the associations between the BMD and the patient’s characteristics: Cross-sectional study: Multivariable linear regression (continuous) Polytomic logistic regression (categorial) Longitudinal study: Linear mixed-effects models (continuous) Generalizated estimating equations (categorical)

  4. Results. Cross sectional analyses. Logistic model.(n= 671) Osteopenia  47.5% (319 patients). Osteoporosis  23% (155 patients).

  5. Results. Longitudinal analyses. Median FU: 2.5 years, IQR (1.2 ; 5.3); 105 pts had >5 years FU Osteopenia First DXA: 49% (193 pts) ; last one: 50% (197 pts) Osteoporosis First DXA: 22% (86 pts) last one:27% (105 pts) Progression  12.5% of the patients progressed to osteopenia 15.6% to osteoporosis. Multivariate GEE model.(n=391)

  6. Conclusions • High prevalence of osteopenia and osteoporosis in our HIV-1+ population. • Factors related were: age, male gender, a low BMI and use of PI and TDF. • These results demonstrate the high frequency of these abnormalities and the need for an early detection and prevention of them.

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