Session 19aOral Abstract Presentations Maternal-Fetal/Pediatrics/Women's Health Session Day and Time: Wednesday 10 am - 12 noon Presentation Time: 11:30 Room: 302-306
102 Low Bone Mineral Density in HIV-infected Women D. Jacobson*, T. Knox, A. Shevitz, S. Gorbach Tufts Univ Sch of Med, Boston, MA
Background: Low Bone Mineral Density (BMD) has been associated with use of antiretroviral medications in HIV infected men. Few observational studies have evaluated the prevalence of osteopenia in women and change in BMD over time.
Methods: We collected annual measurements of total BMD by DXA scan (Hologic QDR 2000), demographics and clinical data in 141 women in the Nutrition for Healthy Living study. On all women, we calculated changes in total BMD over 9-18 months (mos) (~1 year) and 21-27 mos (~2 yrs) of follow-up and evaluated differences of demographic and clinical measures by multiple linear regression. We computed T-scores and prevalence of osteopenia (T score, < -1 SD) at first DXA and at any DXA among Caucasian women (n = 44) for which norms exist.
Results: The female cohort is 33% Caucasian, 52% African American, and 22% other with a median age of 39 years (25th% 35; 75th% 44). The median total BMD at first DXA was 1.09 gm/cm2 (25th% 1.04; 75th% 1.16). After adjusting for age and weight, neither HAART use nor demographic variables were significantly associated with total BMD. The median change in total BMD over approximately 1 yr (n = 61) was -0.001 gm/cm2 (25th% -0.016; 75th% +0.01). The median change at 2 yrs (n = 42) was -0.01 gm/cm2 (25th% -0.026; 75th% +0.006). Change in BMD over 2 yrs is not related to race. There is a significant positive correlation between change in BMD and change in lean body mass over the same interval when adjusted for age, HAART use, viral load, and CD4 count at first DXA. Forty-three percent (43%, 19/44) of Caucasian women had osteopenia at first DXA (n = 14) or in follow-up (n = 5). Most of these women (63%, 12/19) had T-scores between -1.0 to -1.5; 6/19 (32%) women had T-scores between -1.5 to -2.5. Only 1 of the 19 (5%) had osteoporosis (T-score < -2.5 SD). There was a trend for women who contracted HIV through injecting drug use (60% vs 30%, p = 0.05) or who had ever smoked (47% vs 0 %, p = 0.06) to have an increased frequency of osteopenia.
Conclusions: Median BMD did not change over 2 yrs in this cohort of women with HIV infection. However, in individuals loss of BMD is associated with loss of lean body mass. Osteopenia is prevalent in HIV-positive Caucasian women. Smoking and injection drug use may increase the risk of osteopenia.
