Epidemiology

HIV and heroin boost bone loss in older men

Last Updated: 2010-08-26 16:14:18 -0400 (Reuters Health)

By David Douglas

NEW YORK (Reuters Health) - Older HIV-infected men, particularly heroin users with AIDS, appear to be at particular risk of reduced bone mineral density (BMD), researchers report in a July 30 online paper in AIDS

"This ongoing bone loss," Dr. Anjali Sharma told Reuters Health by email, "may place them at increased risk for fractures as they survive into older age, although we could not determine fracture risk from our study."

Dr. Sharma of the University of New York Downstate Medical Center, Brooklyn, and colleagues conducted a prospective cohort study of 230 HIV-infected and 159 HIV-uninfected men aged at least 49 years.

At baseline, 46% had normal BMD, 42% had osteopenia, and 12% had osteoporosis. After a mean of about 32 months of follow-up, 12% of the men with osteopenia progressed to osteoporosis and 83% continued to have osteopenia. Osteoporosis incidence was thus 2.2 per 100 person-years at risk in those with osteopenia.

Overall, osteopenia incidence per 100 person-years at risk was 2.6 for HIV-uninfected men and 7.2 for HIV-infected men.

Multivariable analysis of annual change in BMD at the femoral neck showed that the greatest bone loss occurred with both AIDS and heroin use. AIDS and heroin use also was associated with bone loss at the total hip, as was current methadone use.

Hepatitis C virus seropositivity was also significantly associated with femoral neck bone loss.

The team point out that "an improved understanding of factors associated with ongoing bone loss and fracture risk is needed to help guide thresholds for assessment of BMD and for osteopenia treatment in HIV-infected persons and opioid users."

Meanwhile, concluded Dr. Sharma, substance users with HIV/AIDS should be screened for osteoporosis and considered for programs to prevent bone loss.

SOURCE: http://link.reuters.com/nyg57n

AIDS 2010.