HIV infection and bone mineral density in middle-aged women

Julia H. Arnsten, Ruth Freeman, Andrea A. Howard, Michelle Floris-Moore, Nanette Santoro, Ellie Schoenbaum

Research output: Contribution to journalArticle

106 Citations (Scopus)

Abstract

Background. Osteopenia is prevalent in persons with human immunodeficiency virus (HIV) infection and is part of a normal sequence of aging in women. Most studies of bone mineral density (BMD) and HIV infection have focused on men or have lacked a comparison group of individuals without HIV infection with similar behavioral risk factors. Methods. We analyzed BMD in 495 middle-aged women (defined as women ≥40 years of age); 263 women had HIV infection, and 232 women were HIV-negative with behavioral risk factors similar to those of the HIV-positive group. Results. The median age of the women in the study was 44 years, 54% were black, and 92% had used illicit drugs. Femoral neck BMD and lumbar spine BMD were reduced in women with HIV infection, compared with women without HIV infection (femoral neck BMD, 1.01 ± 0.13 g/cm2 vs. 1.05 ± 0.13 g/cm2; P = .001; lumbar spine BMD, 1.21 ± 0.17 g/cm2 vs. 1.24 ± 0.17 g/cm2; P = .04). In addition to HIV infection, other factors independently associated with lower BMD in both sites were being older, not being black, and having a low body weight. In race-stratified multivariate analyses, HIV infection was associated with BMD only in non-black women. Among HIV-positive women, 84% had taken antiretrovirals, and 62% had taken protease inhibitors, but their use was not associated with BMD. Methadone treatment was also independently associated with reduced lumbar spine BMD. Conclusion. Middle-aged women with HIV infection have reduced BMD, compared with women at similar risk for HIV infection, independent of antiretroviral use. Among HIV-positive women, those who are not black, who are underweight, and who use opiates may be at particular risk. Although the prevalence of reduced BMD in this cohort was higher among women with HIV infection than among those without (27% vs. 19%), the overall prevalence of reduced BMD was low, compared with national estimates and with previous studies involving HIV-positive women and men.

Original languageEnglish (US)
Pages (from-to)1014-1020
Number of pages7
JournalClinical Infectious Diseases
Volume42
Issue number7
DOIs
StatePublished - Apr 1 2006

Fingerprint

Virus Diseases
Bone Density
HIV
Spine
Femur Neck
Opiate Alkaloids
Thinness
Metabolic Bone Diseases
Methadone
Street Drugs
Protease Inhibitors

ASJC Scopus subject areas

  • Immunology

Cite this

HIV infection and bone mineral density in middle-aged women. / Arnsten, Julia H.; Freeman, Ruth; Howard, Andrea A.; Floris-Moore, Michelle; Santoro, Nanette; Schoenbaum, Ellie.

In: Clinical Infectious Diseases, Vol. 42, No. 7, 01.04.2006, p. 1014-1020.

Research output: Contribution to journalArticle

Arnsten, JH, Freeman, R, Howard, AA, Floris-Moore, M, Santoro, N & Schoenbaum, E 2006, 'HIV infection and bone mineral density in middle-aged women', Clinical Infectious Diseases, vol. 42, no. 7, pp. 1014-1020. https://doi.org/10.1086/501015
Arnsten, Julia H. ; Freeman, Ruth ; Howard, Andrea A. ; Floris-Moore, Michelle ; Santoro, Nanette ; Schoenbaum, Ellie. / HIV infection and bone mineral density in middle-aged women. In: Clinical Infectious Diseases. 2006 ; Vol. 42, No. 7. pp. 1014-1020.
@article{2a62bf7f6be64ba8bbd73b9625fde6e5,
title = "HIV infection and bone mineral density in middle-aged women",
abstract = "Background. Osteopenia is prevalent in persons with human immunodeficiency virus (HIV) infection and is part of a normal sequence of aging in women. Most studies of bone mineral density (BMD) and HIV infection have focused on men or have lacked a comparison group of individuals without HIV infection with similar behavioral risk factors. Methods. We analyzed BMD in 495 middle-aged women (defined as women ≥40 years of age); 263 women had HIV infection, and 232 women were HIV-negative with behavioral risk factors similar to those of the HIV-positive group. Results. The median age of the women in the study was 44 years, 54{\%} were black, and 92{\%} had used illicit drugs. Femoral neck BMD and lumbar spine BMD were reduced in women with HIV infection, compared with women without HIV infection (femoral neck BMD, 1.01 ± 0.13 g/cm2 vs. 1.05 ± 0.13 g/cm2; P = .001; lumbar spine BMD, 1.21 ± 0.17 g/cm2 vs. 1.24 ± 0.17 g/cm2; P = .04). In addition to HIV infection, other factors independently associated with lower BMD in both sites were being older, not being black, and having a low body weight. In race-stratified multivariate analyses, HIV infection was associated with BMD only in non-black women. Among HIV-positive women, 84{\%} had taken antiretrovirals, and 62{\%} had taken protease inhibitors, but their use was not associated with BMD. Methadone treatment was also independently associated with reduced lumbar spine BMD. Conclusion. Middle-aged women with HIV infection have reduced BMD, compared with women at similar risk for HIV infection, independent of antiretroviral use. Among HIV-positive women, those who are not black, who are underweight, and who use opiates may be at particular risk. Although the prevalence of reduced BMD in this cohort was higher among women with HIV infection than among those without (27{\%} vs. 19{\%}), the overall prevalence of reduced BMD was low, compared with national estimates and with previous studies involving HIV-positive women and men.",
author = "Arnsten, {Julia H.} and Ruth Freeman and Howard, {Andrea A.} and Michelle Floris-Moore and Nanette Santoro and Ellie Schoenbaum",
year = "2006",
month = "4",
day = "1",
doi = "10.1086/501015",
language = "English (US)",
volume = "42",
pages = "1014--1020",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Oxford University Press",
number = "7",

}

TY - JOUR

T1 - HIV infection and bone mineral density in middle-aged women

AU - Arnsten, Julia H.

AU - Freeman, Ruth

AU - Howard, Andrea A.

AU - Floris-Moore, Michelle

AU - Santoro, Nanette

AU - Schoenbaum, Ellie

PY - 2006/4/1

Y1 - 2006/4/1

N2 - Background. Osteopenia is prevalent in persons with human immunodeficiency virus (HIV) infection and is part of a normal sequence of aging in women. Most studies of bone mineral density (BMD) and HIV infection have focused on men or have lacked a comparison group of individuals without HIV infection with similar behavioral risk factors. Methods. We analyzed BMD in 495 middle-aged women (defined as women ≥40 years of age); 263 women had HIV infection, and 232 women were HIV-negative with behavioral risk factors similar to those of the HIV-positive group. Results. The median age of the women in the study was 44 years, 54% were black, and 92% had used illicit drugs. Femoral neck BMD and lumbar spine BMD were reduced in women with HIV infection, compared with women without HIV infection (femoral neck BMD, 1.01 ± 0.13 g/cm2 vs. 1.05 ± 0.13 g/cm2; P = .001; lumbar spine BMD, 1.21 ± 0.17 g/cm2 vs. 1.24 ± 0.17 g/cm2; P = .04). In addition to HIV infection, other factors independently associated with lower BMD in both sites were being older, not being black, and having a low body weight. In race-stratified multivariate analyses, HIV infection was associated with BMD only in non-black women. Among HIV-positive women, 84% had taken antiretrovirals, and 62% had taken protease inhibitors, but their use was not associated with BMD. Methadone treatment was also independently associated with reduced lumbar spine BMD. Conclusion. Middle-aged women with HIV infection have reduced BMD, compared with women at similar risk for HIV infection, independent of antiretroviral use. Among HIV-positive women, those who are not black, who are underweight, and who use opiates may be at particular risk. Although the prevalence of reduced BMD in this cohort was higher among women with HIV infection than among those without (27% vs. 19%), the overall prevalence of reduced BMD was low, compared with national estimates and with previous studies involving HIV-positive women and men.

AB - Background. Osteopenia is prevalent in persons with human immunodeficiency virus (HIV) infection and is part of a normal sequence of aging in women. Most studies of bone mineral density (BMD) and HIV infection have focused on men or have lacked a comparison group of individuals without HIV infection with similar behavioral risk factors. Methods. We analyzed BMD in 495 middle-aged women (defined as women ≥40 years of age); 263 women had HIV infection, and 232 women were HIV-negative with behavioral risk factors similar to those of the HIV-positive group. Results. The median age of the women in the study was 44 years, 54% were black, and 92% had used illicit drugs. Femoral neck BMD and lumbar spine BMD were reduced in women with HIV infection, compared with women without HIV infection (femoral neck BMD, 1.01 ± 0.13 g/cm2 vs. 1.05 ± 0.13 g/cm2; P = .001; lumbar spine BMD, 1.21 ± 0.17 g/cm2 vs. 1.24 ± 0.17 g/cm2; P = .04). In addition to HIV infection, other factors independently associated with lower BMD in both sites were being older, not being black, and having a low body weight. In race-stratified multivariate analyses, HIV infection was associated with BMD only in non-black women. Among HIV-positive women, 84% had taken antiretrovirals, and 62% had taken protease inhibitors, but their use was not associated with BMD. Methadone treatment was also independently associated with reduced lumbar spine BMD. Conclusion. Middle-aged women with HIV infection have reduced BMD, compared with women at similar risk for HIV infection, independent of antiretroviral use. Among HIV-positive women, those who are not black, who are underweight, and who use opiates may be at particular risk. Although the prevalence of reduced BMD in this cohort was higher among women with HIV infection than among those without (27% vs. 19%), the overall prevalence of reduced BMD was low, compared with national estimates and with previous studies involving HIV-positive women and men.

UR - http://www.scopus.com/inward/record.url?scp=33645062397&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33645062397&partnerID=8YFLogxK

U2 - 10.1086/501015

DO - 10.1086/501015

M3 - Article

C2 - 16511769

AN - SCOPUS:33645062397

VL - 42

SP - 1014

EP - 1020

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 7

ER -