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Session 94 Poster Session Osteopenia/Osteoporosis Session Time: 4:30-6:30 pm Room 4E-F

718-T. Longitudinal Evolution of Bone Mineral Density (BMD) and Bone Markers in HIV-Infected Individuals K. Mondy*, S. Lassa-Claxton, M. Hoffmann, K. Yarasheski, W. G. Powderly, and P. Tebas Washington Univ. Sch. of Med., St. Louis, MO Background: Osteopenia/osteoporosis has been associated both with HIV infection and its treatment. The relative contribution of each is not known. There are little data available about the change in BMD over time in patients with HIV infection taking different antiretroviral regimens. Methods: A longitudinal cohort study is being conducted at Washington University to evaluate the long-term evolution of BMD and bone markers in HIV-infected individuals. All patients underwent localized DEXAs (hip and spine) and evaluation of bone markers at 24-week intervals. 128 patients have been enrolled. 48-week follow-up is available in 55 of them. 2 patients who started alendronate were excluded. Results: Most patients were male (85%), Caucasian (82%), and taking PI-based regimens (68%). 40% were smokers, 41% occasional drinkers. 61% had calcium intakes < 1000 mg/d (RDA), 9% were taking calcium supplements at baseline, 35% at week 48; 44% had moderate to high levels of physical activity. Median BMI was 24 (IQR 22-28). At baseline 47% of the subjects had osteopenia/osteoporosis. Median lumbar and hip t scores were -0.90 (IQR -0.3 to -1.7) and -0.93 (IQR -0.2 to -1.6), respectively. There was no association with any antiretroviral class. Patients as a group had evidence of high bone turnover. There was a small, but significant, increase in lumbar and hip BMD for the whole group during the 48-week follow-up (lumbar 2.3% ± 0.5% p <0.0001, hip 2.2% ± 0.5% p <0.0001). Patients that started therapy (n=4) tended to have lower improvement in lumbar BMD (- 0.4 % vs 2.6% p=0.11) but no differences in the hip (2.6% vs 2.2% p=0.81) when compared to patients in any or no therapy during the 48 weeks. There were no significant changes during the 48 weeks in markers of bone formation (bone-specific alkaline phosphatase, osteocalcin) and bone resorption (urine pyridinolines, deoxypyridinolines). Conclusions: Osteopenia/osteoporosis is a frequent problem among HIV-infected patients. During 1-year follow-up subjects receiving antiretroviral therapy had a slight improvement in BMD, suggesting either that therapy itself might not be the most significant contributing factor for the development of this problem or that the effect of treatment on bone occurs early after its initiation. Longer follow-up is necessary to evaluate the long-term impact of HIV infection and therapy on bone metabolism in the HIV-infected population.

©2002 9th Conference on Retroviruses and Opportunistic Infections