Young men being treated for HIV are more likely to experience low bone mass than are other men their age, according research published in Clinical Infectious Diseases.
The findings of the study, Low Bone Mass in Behaviorally HIV-Infected Young Men on Antiretroviral Therapy, indicates that patients being treated for HIV should be monitored for signs of bone thinning, which may lead to fractures.
The study was conducted at 15 clinical adolescent network sites, including the Pediatric Clinical Research Center (PCRC) in San Francisco managed by the Clinical Research Services (CRS) program at UCSF’s Clinical and Translational Science Institute (CTSI). Barbara Moscicki, MD, a UCSF professor of medicine, served as the local Principal Investigator.
“The assistance of the PCRC is invaluable for these types of studies,” said co-author Kathleen Mulligan, Ph.D., an associate professor of medicine and director of the CRS Body Composition, Exercise, and Metabolism Core. “It provides expert nursing and research support in a youth-friendly setting, which is essential for quality research in this vulnerable group.”
The primary outcome of the study, bone density, was measured by dual-energy X-ray absorptiometry (DXA), which is currently available through the Body Composition, Exercise, and Metabolism Core at UCSF.
Some 250 teens and young men (14 to 25 years old) participated in the study. About 88 percent of the study participants identified themselves as African-American or Hispanic and all lived in urban areas. The participants underwent whole body scans to measure their bone density as well as the distribution of fat and lean muscle mass in certain regions of their bodies. Participants also answered questions about their medical history, and diet, exercise and other lifestyle habits.
Both bone density and the calcium and other mineral content of bones tended to be lowest in participants taking medication for HIV. Youth with HIV who had not begun treatment had higher bone mass levels than HIV positive youth who were on anti-HIV regimens, but lower bone mass levels than youth who did not have HIV.
Participants' responses to questions about diet indicated that at least half of them did not consume sufficient calcium or vitamin D. The researchers also found that more than 30 percent of all the participants smoked, and half said they did not get regular exercise. Smoking and lack of exercise can contribute to weaker bones. The study authors noted that additional studies are needed to follow HIV-positive young men long term to determine whether bone loss during adolescence increases the risk of fractures later in life.
“None of the young men we saw is in immediate risk of fracture,” said Dr. Mulligan. “However, our results indicated that it would be a good idea for young men newly diagnosed with HIV to make sure they exercise, get enough calcium and vitamin D, quit smoking and limit alcohol consumption.”
CTSI is a member of the National Institutes of Health-funded Clinical and Translational Science Awards network. Under the banner of Accelerating Research to Improve Health, the Institute provides a wide range of services for researchers, and promotes online collaboration and networking tools such as UCSF Profiles.