changes in bone turnover and bone loss in hiv-infected patients changing treatment to tenofovir-emtricitabine or abacavir-lamivudine骨代谢的变化和艾滋病毒感染患者的骨质流失tenofovir-emtricitabine或abacavir-lamivudine改变治疗.pdfVIP

Changes in Bone Turnover and Bone Loss in HIV-Infected Patients Changing Treatment to Tenofovir-Emtricitabine or Abacavir-Lamivudine 1 2 1 3 1 4 Hila Haskelberg *, Jennifer F. Hoy , Janaki Amin , Peter R. Ebeling , Sean Emery , Andrew Carr , STEAL Study Group 1The Kirby Institute, University of New South Wales, Sydney, Australia, 2 Infectious Diseases Unit, The Alfred Hospital, Monash University, Melbourne, Australia, 3 North West Academic Centre, University of Melbourne, Melbourne, Australia, 4 St. Vincent’s Hospital, Sydney, Australia Abstract Background: Those receiving tenofovir/emtricitabine (TDF-FTC) had greater bone loss compared with abacavir/lamivudine (ABC-3TC) in a randomized simplification trial (STEAL study). Previous studies associated increased bone turnover and bone loss with initiation of antiretroviral treatment, however it is unclear whether change in bone mineral density (BMD) was a result of specific drugs, from immune reconstitution or from suppression of HIV replication. This analysis determined predictors of BMD change in the hip and spine by dual-energy x-ray absorptiometry in virologically suppressed participants through week 96. Methodology/Principal Findings: Bone turnover markers (BTMs) tested were: formation [bone alkaline phosphatase, procollagen type 1 N-terminal propeptide (P1NP)]; resorption (C-terminal cross-linking telopeptide of type 1 collagen [CTx]); and bone cytokine-signalling (osteoprotegerin, RANK ligand). Independent predictors of BMD change were determined using forward, stepwise, linear regression. BTM changes and fracture risk (F