Controlled HIV viral replication, not liver disease severity associated with low bone mineral density in HIV/HCV co-infection

Diala El-Maouche, Shruti H. Mehta, Catherine Sutcliffe, Yvonne Higgins, Michael S. Torbenson, Richard D. Moore, David L. Thomas, Mark S. Sulkowski, Todd T. Brown

Research output: Contribution to journalArticle

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Abstract

Background & Aims: To evaluate the prevalence and risk factors for low bone mineral density (BMD) in persons co-infected with HIV and Hepatitis C. Methods: HIV/HCV co-infected study participants (n = 179) were recruited into a prospective cohort and underwent dual-energy X-ray absorptiometry (DXA) within 1 year of a liver biopsy. Fibrosis staging was evaluated according to the METAVIR system. Osteoporosis was defined as a T-score ≤-2.5. Z-scores at the total hip, femoral neck, and lumbar spine were used as the primary outcome variables to assess the association between degree of liver disease, HIV-related variables, and BMD. Results: The population was 65% male, 85% Black with mean age 50.3 years. The prevalence of osteoporosis either at the total hip, femoral neck, or lumbar spine was 28%, with 5% having osteoporosis of the total hip, 6% at the femoral neck, 25% at the spine. The mean Z-scores (standard deviation) were -0.42 (1.01) at the total hip, -0.16 (1.05) at the femoral neck, and -0.82 (1.55) at the lumbar spine. In multivariable models, controlled HIV replication (HIV RNA <400 copies/ml vs. ≥400 copies/ml) was associated with lower Z-scores (mean ± standard error) at the total hip (-0.44 ± 0.17, p = 0.01), femoral neck (-0.59 ± 0.18, p = 0.001), and the spine (-0.98 ± 0.27, p = 0.0005). There was no association between degree of liver fibrosis and Z-score. Conclusions: Osteoporosis was very common in this population of predominately African-American HIV/HCV co-infected patients, particularly at the spine. Lower BMD was associated with controlled HIV replication, but not liver disease severity.

Original languageEnglish (US)
Pages (from-to)770-776
Number of pages7
JournalJournal of Hepatology
Volume55
Issue number4
DOIs
StatePublished - Oct 2011
Externally publishedYes

Fingerprint

Coinfection
Bone Density
Liver Diseases
Femur Neck
HIV
Spine
Hip
Osteoporosis
Photon Absorptiometry
Hepatitis C
Liver Cirrhosis
African Americans
Population
Fibrosis
RNA
Biopsy
Liver

Keywords

  • Bone mineral density
  • Hepatic fibrosis
  • Hepatitis C
  • HIV

ASJC Scopus subject areas

  • Hepatology

Cite this

El-Maouche, D., Mehta, S. H., Sutcliffe, C., Higgins, Y., Torbenson, M. S., Moore, R. D., ... Brown, T. T. (2011). Controlled HIV viral replication, not liver disease severity associated with low bone mineral density in HIV/HCV co-infection. Journal of Hepatology, 55(4), 770-776. https://doi.org/10.1016/j.jhep.2011.01.035

Controlled HIV viral replication, not liver disease severity associated with low bone mineral density in HIV/HCV co-infection. / El-Maouche, Diala; Mehta, Shruti H.; Sutcliffe, Catherine; Higgins, Yvonne; Torbenson, Michael S.; Moore, Richard D.; Thomas, David L.; Sulkowski, Mark S.; Brown, Todd T.

In: Journal of Hepatology, Vol. 55, No. 4, 10.2011, p. 770-776.

Research output: Contribution to journalArticle

El-Maouche, D, Mehta, SH, Sutcliffe, C, Higgins, Y, Torbenson, MS, Moore, RD, Thomas, DL, Sulkowski, MS & Brown, TT 2011, 'Controlled HIV viral replication, not liver disease severity associated with low bone mineral density in HIV/HCV co-infection', Journal of Hepatology, vol. 55, no. 4, pp. 770-776. https://doi.org/10.1016/j.jhep.2011.01.035
El-Maouche, Diala ; Mehta, Shruti H. ; Sutcliffe, Catherine ; Higgins, Yvonne ; Torbenson, Michael S. ; Moore, Richard D. ; Thomas, David L. ; Sulkowski, Mark S. ; Brown, Todd T. / Controlled HIV viral replication, not liver disease severity associated with low bone mineral density in HIV/HCV co-infection. In: Journal of Hepatology. 2011 ; Vol. 55, No. 4. pp. 770-776.
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AU - Sutcliffe, Catherine

AU - Higgins, Yvonne

AU - Torbenson, Michael S.

AU - Moore, Richard D.

AU - Thomas, David L.

AU - Sulkowski, Mark S.

AU - Brown, Todd T.

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AB - Background & Aims: To evaluate the prevalence and risk factors for low bone mineral density (BMD) in persons co-infected with HIV and Hepatitis C. Methods: HIV/HCV co-infected study participants (n = 179) were recruited into a prospective cohort and underwent dual-energy X-ray absorptiometry (DXA) within 1 year of a liver biopsy. Fibrosis staging was evaluated according to the METAVIR system. Osteoporosis was defined as a T-score ≤-2.5. Z-scores at the total hip, femoral neck, and lumbar spine were used as the primary outcome variables to assess the association between degree of liver disease, HIV-related variables, and BMD. Results: The population was 65% male, 85% Black with mean age 50.3 years. The prevalence of osteoporosis either at the total hip, femoral neck, or lumbar spine was 28%, with 5% having osteoporosis of the total hip, 6% at the femoral neck, 25% at the spine. The mean Z-scores (standard deviation) were -0.42 (1.01) at the total hip, -0.16 (1.05) at the femoral neck, and -0.82 (1.55) at the lumbar spine. In multivariable models, controlled HIV replication (HIV RNA <400 copies/ml vs. ≥400 copies/ml) was associated with lower Z-scores (mean ± standard error) at the total hip (-0.44 ± 0.17, p = 0.01), femoral neck (-0.59 ± 0.18, p = 0.001), and the spine (-0.98 ± 0.27, p = 0.0005). There was no association between degree of liver fibrosis and Z-score. Conclusions: Osteoporosis was very common in this population of predominately African-American HIV/HCV co-infected patients, particularly at the spine. Lower BMD was associated with controlled HIV replication, but not liver disease severity.

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