The Prevalence and Associated Factors of Reduced Bone Mineral Density (BMD) Among Men with Suppressed Viral Load Taking Antiretroviral Therapy

Abstract

Background: Reduced bone mineral density (BMD) is a frequent comorbidity observed in people living with HIV (PLHIV).

Objective: The aim of the study is to determine the prevalence and associated factors of reduced bone mineral density (BMD) among men with suppressed viral load taking antiretroviral therapy.

Methods: The study was conducted as a cross-sectional design between January to April 2019. 211 patients were included in the study. Z-score at either body site between -1.0 and -2.0 or -2 or less was defined as osteopenia or osteoporosis, respectively. Multivariate logistic regression analysis was used to evaluate the factors affecting the development of reduced BMD.

Results: The mean age of the patients involved in the study was 34.8 ± 7.6. Osteoporosis was detected in 21.4% and osteopenia in 44.5% of the patients. There was a significant relationship found between HIV diagnosis time, ART usage duration, tenofovir disoproxil fumarate (TDF) use, TDF use in the past, total TDF usage time and decreased BMD. Multivariate logistic regression analysis showed that the likelihood of reduced bone marrow density was 67% lower among those with regular milk or dairy product intake compared to those without (OR=0.330; 95% CI = 0.12-0.92, p=0.033).

Conclusion: There is a high prevalence of reduced BMD among PLHIV aged under 50, which is mainly confounded by HIV diagnosis time, ART usage duration and TDF usage. Although virological control has been achieved, these patients should be followed up, considering that they may have decreased BMD.

Keywords: HIV/AIDS; PLHIV.; TDF; bone mineral density; osteoporosis; risk factors.