TDF and quantitative ultrasound bone quality in African patients on second line ART, ANRS 12169 2LADY sub-study

Bone demineralization, which leads to osteoporosis and increased fracture risk, is a common metabolic disorder in HIV-infected individuals. In this study, we aimed to assess the change in bone quality using quantitative ultrasound (QUS) over 96 weeks of follow-up after initiation of second-line trea...

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Published in:PloS one 2017-11, Vol.12 (11), p.e0186686
Main Authors: Kabore, Firmin Nongodo, Eymard-Duvernay, Sabrina, Zoungrana, Jacques, Badiou, Stéphanie, Bado, Guillaume, Héma, Arsène, Diouf, Assane, Delaporte, Eric, Koulla-Shiro, Sinata, Ciaffi, Laura, Cournil, Amandine
Format: Article
Language:English
Subjects:
Adult
Age
Analysis
Antiretroviral agents
Antiretroviral drugs
Antiretroviral Therapy, Highly Active
Biocompatibility
Biology and Life Sciences
Biomedical materials
Birth control
Body mass
Body mass index
Body size
Bone and Bones - drug effects
Bone and Bones - physiopathology
Bone demineralization
Bone Demineralization, Pathologic - drug therapy
Bone Demineralization, Pathologic - etiology
Bone Demineralization, Pathologic - physiopathology
Bone Demineralization, Pathologic - virology
Bone density
Bone Density - drug effects
Bone Density - physiology
Bone diseases
Burkina Faso
Calcaneus
Cameroon
Care and treatment
CD4 antigen
Demineralization
Demineralizing
Diagnosis
Emtricitabine - therapeutic use
Exercise
Exposure
Female
Highly active antiretroviral therapy
HIV
HIV Infections - complications
HIV Infections - drug therapy
HIV Infections - physiopathology
HIV Infections - virology
HIV-1 - pathogenicity
Hospitals
Human immunodeficiency virus
Humans
Identification methods
Infections
Infectious diseases
Laboratories
Life Sciences
Male
Medicine and Health Sciences
Metabolic disorders
Metabolism
Middle Aged
Osteoporosis
Osteoporosis - drug therapy
Osteoporosis - etiology
Osteoporosis - physiopathology
Osteoporosis - virology
Patients
Physical sciences
Quality
Quality assessment
Risk factors
Senegal
Sex
Stiffness
Studies
Tenofovir - therapeutic use
Tuberculosis
Ultrasonic imaging
Ultrasound
Vitamin D
Vitamin deficiency
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Summary:Bone demineralization, which leads to osteoporosis and increased fracture risk, is a common metabolic disorder in HIV-infected individuals. In this study, we aimed to assess the change in bone quality using quantitative ultrasound (QUS) over 96 weeks of follow-up after initiation of second-line treatment, and to identify factors associated with change in bone quality. In a randomized trial (ANRS 12169), TDF and PI-naïve participants failing standard first-line treatment, from Burkina Faso, Cameroon, and Senegal were randomized to receive either TDF/FTC/LPVr, ABC/ddI/LPVr or TDF/FTC/DRVr. Their bone quality was assessed using calcaneal QUS at baseline and every 24 weeks until week 96. Stiffness index (SI) was used to measure bone quality. Out of 228 participants, 168 (74%) were women. At baseline, median age was 37 years (IQR: 33-46 years) and median T-CD4 count was 199 cells/μl (IQR: 113-319 cells/μl). The median duration of first-line antiretroviral treatment (ART) was 52 months (IQR: 36-72 months) and the median baseline SI was 101 (IQR: 87-116). In multivariable analysis, factors associated with baseline SI were sex (β = -10.8 [-18.1,-3.5] for women), age (β = -8.7 [-12.4,-5.1] per 10 years), body mass index (BMI) (β = +0.8 [0.1,1.5] per unit of BMI), and study site (β = +12.8 [6.5,19.1] for Cameroon). After 96 weeks of second-line therapy, a reduction of 7.1% in mean SI was observed, as compared with baseline. Factors associated with SI during the follow-up were similar to those found at baseline. Exposure to TDF was not associated with a greater loss of bone quality over time. Bone quality decreased after second-line ART initiation in African patients independently of TDF exposure. Factors associated with bone quality include age, sex, baseline BMI, study site, and duration of follow-up.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0186686