Risk factors for low bone mineral density (BMD)

107 Spanish HIV-positive patients on antiretroviral therapy were evaluated in a cross-sectional study for risk factors for low BMD. BMD of lumbar spine and femoral neck was measured with dual-energy X-ray absorptiometry and a multivariate analysis was performed including HIV-status, antiretroviral drugs and traditional risk factor. 63 participants (58.9 %) were diagnosed with low BMD including 11 participants with osteoporosis. In the multivariate analysis, treatment with a boosted protease inhibitor in combination with tenofovir disoproxil fumarate (TDF) and previous exposure to TDF were independent risk factors for low BMD. Traditional risk factors like older age, smoking, opiate use etc. were also risk factors for low BMD.

Cervero et al. PLOS ONE 2018;published 30 Apr: https://doi.org/10.1371/journal.pone.0196201

Comment: The likely explanation for the increased risk of low BMD in patients treated with boosted protease inhibitors and TDF is the interaction between the booster and TDF resulting in higher TDF levels.