伊朗艾滋病毒感染者低骨密度的累积发病率和治疗效果(2021-2023)

IF 2.1 4区 医学 Q3 INFECTIOUS DISEASES AIDS Research and Therapy Pub Date : 2024-12-18 DOI:10.1186/s12981-024-00683-8
Hamidreza Rashidi, Soheil Mehmandoost, Noushin Fahimfar, Seyed Mohammad Hosseinian, Mohammad Reza Shakibi, Tarlan Hasan Aghaei, Farzaneh Yazdi Yahaabadi, Pouriya Salajegheh, Willi Mcfarland, Afshin Ostovar, Hamid Sharifi
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引用次数: 0

摘要

背景:抗逆转录病毒治疗(ART)的引入显著提高了艾滋病毒感染者(PLHIV)的预期寿命,导致骨质疏松症等年龄相关合并症的患病率增加。本研究调查了伊朗Kerman地区PLHIV患者低骨密度(BMD)的发生率和特征,以及低骨密度参与者的治疗效果。方法:一项纵向研究利用双能x线吸收仪(DEXA)筛查伊朗Kerman的94例低骨密度PLHIV患者。参与者年龄在30岁或以上,接受抗逆转录病毒治疗(ART)至少12个月。那些骨密度低的人进入单臂临床试验并接受适当的治疗。这些人在治疗完成11个月后接受检查以评估治疗效果。那些骨密度正常的人进入了一项队列研究,并检查了低骨密度的累积发生率。收集了人口统计、病史和实验室检测数据。使用卡方检验来评估分类变量之间的相关性。采用t检验(对于正态分布变量)或Mann-Whitney U检验(对于非正态分布变量)来评估两组之间骨密度的差异。p≤0.05,差异有统计学意义,分析见Stata 17。结果:基线时94例PLHIV患者中,48例(51%)骨密度低。随访期间,11名参与者(11.7%)错过随访。在随访中,有83例PLHIV患者(40例骨密度低,43例基线骨密度正常)。在接受治疗的40名参与者中,5名骨密度正常(治疗效果:12.5%)。然而,在43例基线时骨密度正常的PLHIV患者中,随访时骨密度低的PLHIV患者有7例(累计发病率16.3%)。在随访期间,体重指数(BMI)较低者的低骨密度发生率高于BMI正常者(p值:0.003)。腰椎骨密度适度增加(0.005 g/cm2),而股骨颈和髋部骨密度下降(分别为0.011和0.007 g/cm2)。在随访中,低骨密度组骨钙素和β-异构c端末端肽(β-CTx)水平较高,表明骨转换增加。结论:该研究强调了伊朗Kerman地区PLHIV患者16.3%的累积发病率和12.5%的低骨密度治疗效果,这与骨折风险有关。尽管脊柱骨密度呈稳定下降状态,但由于股骨颈和全髋骨密度持续下降,骨折的风险仍然升高。性别因素和BMI可能影响对低骨密度的易感性。
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Cumulative incidence and treatment effectiveness of low bone mineral density among people living with HIV in Iran (2021-2023).

Background: The introduction of antiretroviral therapy (ART) has significantly improved the life expectancy of people living with HIV (PLHIV), leading to an increased prevalence of age-related comorbidities such as osteoporosis. This study investigates the incidence and characteristics of low bone mineral density (BMD) and the treatment effectiveness of low BMD participants among PLHIV in Kerman, Iran.

Methods: A longitudinal study utilized dual-energy X-ray absorptiometry (DEXA) to screen 94 PLHIV in Kerman, Iran, for low BMD. Participants were aged 30 or older and had received antiretroviral therapy (ART) for at least 12 months. Those with low BMD were entered into a single-arm clinical trial and received the appropriate treatment. These people were checked to assess the treatment effectiveness 11 months after completion of the treatment. Those with normal BMD entered a cohort study and were checked to determine the cumulative incidence of low BMD. Data on demographics, medical history, and laboratory tests were collected. A chi-square test was used to assess the association between the categorical variables. A t-test (for normally distributed variables), or Mann-Whitney U (for non-normally distributed variables) was used to assess the differences of BMD between the two groups. Statistical significance was set at p ≤ 0.05, with analyses conducted in Stata 17.

Results: Among 94 PLHIV at baseline, 48 participants (51%) had low BMD. During the follow-up, 11 participants (11.7%) missed the follow-up visits. In the follow-up, 83 PLHIV (40 with low BMD and 43 with normal BMD at baseline) were available. Among 40 participants who received treatment, 5 had normal BMD (treatment effectiveness: 12.5%). However, among 43 PLHIV with normal BMD at baseline, 7 PLHIV had low BMD at the follow-up visit (cumulative Incidence 16.3%). Those with lower body mass index (BMI) had a higher prevalence of low BMD than those with normal BMI during the follow-up (p-value: 0.003). Lumbar spine BMD increased modestly (0.005 g/cm2), while femoral neck and total hip BMD declined in total participants (0.011, 0.007 g/cm2, respectively). Osteocalcin and β-isomerized C-terminal telopeptides (β-CTx) levels were higher in the low BMD group in the follow-up, indicating increased bone turnover.

Conclusions: The study highlights the high cumulative incidence of 16.3% and treatment effectiveness of 12.5% of low BMD among PLHIV in Kerman, Iran, with implications for fracture risk. Despite a steady state in spine BMD decline, the risk of fracture remains elevated due to continued femoral neck and total hip BMD reduction. Gender-specific factors and BMI may influence susceptibility to low BMD.

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来源期刊
AIDS Research and Therapy
AIDS Research and Therapy INFECTIOUS DISEASES-
CiteScore
3.80
自引率
4.50%
发文量
51
审稿时长
16 weeks
期刊介绍: AIDS Research and Therapy publishes articles on basic science, translational, clinical, social, epidemiological, behavioral and educational sciences articles focused on the treatment and prevention of HIV/AIDS, and the search for the cure. The Journal publishes articles on novel and developing treatment strategies for AIDS as well as on the outcomes of established treatment strategies. Original research articles on animal models that form an essential part of the AIDS treatment research are also considered
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