Antiretroviral therapy, especially Efavirenz, is associated with low bone mineral density in HIV-infected South Africans

 

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dc.contributor.author Dave, Joel A en_ZA
dc.contributor.author Cohen, Karen en_ZA
dc.contributor.author Micklesfield, Lisa K en_ZA
dc.contributor.author Maartens, Gary en_ZA
dc.contributor.author Levitt, Naomi S en_ZA
dc.date.accessioned 2015-12-20T16:04:16Z
dc.date.available 2015-12-20T16:04:16Z
dc.date.issued 2015 en_ZA
dc.identifier.citation Dave, J. A., Cohen, K., Micklesfield, L. K., Maartens, G., & Levitt, N. S. (2015). Antiretroviral therapy, especially Efavirenz, is associated with low bone mineral density in HIV-infected South Africans. PloS one, 10(12). doi:10.1371/journal.pone.0144286 en_ZA
dc.identifier.uri http://hdl.handle.net/11427/15912
dc.identifier.uri http://dx.doi.org/10.1371/journal.pone.0144286
dc.description.abstract Purpose We determined the prevalence and correlates of low bone mineral density (BMD) in HIV-infected South Africans as there is a paucity of such data from Africa. METHODS: BMD and serum 25-hydroxyvitamin D were measured in HIV-positive participants on antiretroviral therapy (ART) and in those not yet on ART (ART-naïve). RESULTS: We enrolled 444 participants [median age 35(IQR: 30, 40) years; 77% women]. BMD was low (z score <-2SD) in 17% and 5% of participants at the lumbar spine and total hip, respectively. Total hip [0.909 (SD 0.123) vs 0.956 (SD 0.124) g/cm 2 , p = 0.0001] and neck of femur BMD [0.796 (SD 0.130) vs 0.844 (SD 0.120) g/cm 2 , p = 0.0001] were lower in the ART, compared to the ART-naïve group. Vitamin D deficiency was present in 15% of participants and was associated with efavirenz use [adjusted OR 2.04 (95% CI 1.01 to 4.13)]. In a multivariate linear regression, exposure to efavirenz or lopinavir-based ART was associated with lower total hip BMD, whereas higher weight, being male and higher vitamin D concentration were associated with higher total hip BMD (adjusted R 2 = 0.28). Age, weight, sex, and the use of efavirenz-based ART were independently associated with lumbar spine BMD (adjusted R 2 = 0.13). CONCLUSIONS: Vitamin D status, use of efavirenz or lopinavir/ritonavir, weight, age and sex are significantly associated with lower BMD in this young cohort of HIV-infected South Africans. en_ZA
dc.language.iso eng en_ZA
dc.publisher Public Library of Science en_ZA
dc.rights This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. en_ZA
dc.rights.uri http://creativecommons.org/licenses/by/4.0 en_ZA
dc.source PLoS One en_ZA
dc.source.uri http://journals.plos.org/plosone en_ZA
dc.subject.other Antiretroviral therapy en_ZA
dc.subject.other Hip en_ZA
dc.subject.other Vitamin D en_ZA
dc.subject.other Vitamin D deficiency en_ZA
dc.subject.other Bone density en_ZA
dc.subject.other HIV infections en_ZA
dc.subject.other Linear regression analysis en_ZA
dc.subject.other Africans en_ZA
dc.title Antiretroviral therapy, especially Efavirenz, is associated with low bone mineral density in HIV-infected South Africans en_ZA
dc.type Journal Article en_ZA
dc.rights.holder © 2015 Dave et al en_ZA
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Division of Endocrinology and Diabetology en_ZA
uct.type.filetype Text
uct.type.filetype Image


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This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Except where otherwise noted, this item's license is described as This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.