Abstract 627 - Equivalent Osteopenia in HIV-Infected Subjects Studied Before and During the Era of HAART.

627 Equivalent Osteopenia in HIV-Infected Subjects Studied Before and During the Era of HAART.

A. Lawal*, E. Engelson, J. Wang, S. Heymsfield, and D. Kotler.
St. Luke's-Roosevelt Hosp. Ctr., New York, NY.

Background:Advances in the treatment of HIV infection, especially the use of highly active antiretroviral agents (HAART), have dramatically reduced morbidity and mortality from HIV infection. Several reports of osteopenia in patients on HAART have been published or presented, and a link to protease inhibitor therapy has been suggested.

Methods:We compared bone mineral content and density in groups of HIV-infected subjects studied prior to or during the era of HAART. Using a case control design, we analyzed baseline dual energy X-ray absorptiometry (DXA) studies from two open label clinical trials. 36 malnourished, HIV-infected men received an anabolic steroid, oxandrolone, in 1993 (pre-HAART) and 22 HIV-infected subjects (19 men and 3 women) with fat redistribution were treated with recombinant human growth hormone (GH) in 1998 (HAART). All subjects were matched to healthy controls by age+5 years, race, sex and height+10cm. GH subjects and controls were also matched by weight+10kg. Analysis was by paired t-test for the means.

Results:The ages of subjects in the pre-HAART and HAART studies were similar (p = 0.28). HAART subjects averaged 15 kg heavier (79.2+13.0 vs. 64.2+5.9, p <0.001), and had more fat free mass and fat (both p <0.001) than subjects in the pre-HAART study. Total bone mineral content (TBMC), calcium (TBCa) and density (TBD) were similar in the two HIV-infected groups (data as mean+standard deviation). However, when compared with case matched controls, both pre-HAART and HAART HIV-infected subjects averaged lower TBMC (g) (2845+303 vs. 3229+464, and 2687+465 vs. 3095+602 respectively, both p <0.001), TBCa (g) (1081+115 vs. 1208+154 and 1030+162 vs. 1198+226, both p <0.001) and TBD (g/cm²) (1.18+0.10 vs. 1.26+0.08 and 1.17+0.09 vs. 1.23+0.10, P = 0.001 and P = 0.004, respectively).

Conclusion:The results of this study suggest that osteopenia is a feature of HIV infection before as well as after treatment with HAART.