Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
AIDS Research and Therapy
Published in: AIDS Research and Therapy 1/2017

Open Access 01-12-2017 | Review

Bone mineral density in people living with HIV: a narrative review of the literature

Authors: M. J. Kruger, T. A. Nell

Published in: AIDS Research and Therapy | Issue 1/2017

Login to get access

Abstract

Bone health status is largely absent in South Africa, the main reasons being the absence and cost-effectiveness of specific screening equipment for assessing bone mineral density (BMD). Various risk factors seem to play a role, some of which can be modified to change bone health status. Urbanisation is also a public health concern. Changing nutritional, as well as social behaviour, play integral roles in the prevalence and incidence of decreased BMD. Furthermore, human immunodeficiency virus (HIV) specifically, has a negative impact on BMD and although highly active antiretroviral therapy increases the prognosis for HIV-infected individuals, BMD still seem to decrease further. Dual energy X-ray absorptiometry is considered the gold standard for BMD assessment; however, recent developments have provided more cost-effective screening methods, among which heel quantitative ultrasound appears to be the most widely used in resource limited countries such as South Africa.
Literature
1.
Hough S, Ascott-Evans BH, Brown SL, Cassim B, de Villiers TJ, Lipschitz S, et al. NOFSA guideline for the diagnosis and management of osteoporosis. J Endocrinol Metab Diabetes S Afr. 2010;15(3):1–188.
2.
Thomas PA. Racial and ethnic differences in osteoporosis. J Am Acad Ortho Surg. 2007;15:S26–30.CrossRef
3.
Kanis JA, Oden A, Johansson H, Borgström F, Ström O, Mccloskey E. FRAX and its application in clinical practice. Bone. 2009;44:734–43.PubMedCrossRef
4.
Cooper C, Cole ZA, Holroyd CR, Earl SC, Harvey NC, Dennison EM, et al. Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int. 2011;22:1277–88.PubMedPubMedCentralCrossRef
5.
National Osteoporosis Foundation. America’s bone health: the state of osteoporosis and low bone mass in our nation. Washington DC: National Osteoporosis Foundation; 2002.
6.
Cooper C, Campion G, Melton LJ. Hip fractures in the eldery: a world-wide projection. Osteoporos Int. 1992;2:287–9.CrossRef
7.
Chantler S, Dickie K, Goedecke JH, Levitt NS, Lambert EV, Evans J, et al. Site-specific differences in bone mineral density in black and white premenopausal South African women. Osteopor Int. 2012;23:533–42.CrossRef
8.
Goedecke JH, Levitt NS, Lambert EV, Utzschneider KM, Faulenbach MV, Dave JA, et al. Differential effects of abdominal adipose tissue distribution on insulin sensitivity in black and white South African women. Obesity. 2009;17:1506–12.PubMedCrossRef
9.
Sumner AE, Micklesfield LK, Ricks M, Tambay AV, Avila NA, Thomas F, et al. Waist circumference, BMI, and visceral adipose tissue in white women and women of African descent. Obesity (Silver Spring). 2011;19(3):671–4.PubMedCrossRef
10.
Sanchez-Riera L, Carnahan E, Vos T, Veerman L, Norman R, Lim SS, et al. The global burden attributable to low bone mineral density. Ann Rheum Dis. 2014;73(9):1635–45.PubMedCrossRef
11.
Stedman’s medical dictionary for the health professions and nursing. 7th ed. Huntingdon Valley: Farlex Inc; 2011.
12.
Segen’s medical dictionary. Huntingdon Valley: Joe Segen and Farlex Inc; 2012.
13.
NIH consensus development panel on osteoporosis prevention, diagnosis and therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA. 2001;285 (6):785-95.
14.
Hough S, Ascott-Evans BH, Brown SL, Cassim B, de Villiers TJ, Lipschitz S, et al. NOFSA guideline for the diagnosis and management of osteoporosis. Executive summary. J Endocrinol Metab Diabetes S Afr. 2010;15(3):107–8.CrossRef
15.
16.
17.
Bachrach LK. Acquisition of optimal bone mass in childhood and adolescence. Trends Endocrinol Metab. 2001;12(1):22–8.PubMedCrossRef
18.
Baxter-Jones AD, Faulkner RA, Forwood MR, Mirwald RL, Bailey DA. Bone mineral accrual from 8 to 30 years of age: an estimation of peak bone mass. J Bone Miner Res. 2011;26(8):1729–39.PubMedCrossRef
19.
Lorentzon M, Mellström D, Ohlsson C. Age of attainment of peak bone mass is site specific in Swedish men–the GOOD study. J Bone Miner Res. 2005;20(7):1223–7.PubMedCrossRef
20.
Crawford PB, Wang MC, Sabry ZI, Hudes M, Van LM, Bachrach LK. Adolescent diet is predictive of peak bone mass. Am J Clin Nutr. 2002;75:356–9.
21.
Walsh IAP, Oishi J, Coury HJCG. Clinical and functional aspects of workrelated musculoskeletal disorders among active workers. Rev Saude Publica. 2008;42:108–16.PubMedCrossRef
22.
Parfitt AM, Chir B. Bone remodeling and bone loss: understanding the pathophysiology of osteoporosis. Clin Obstet Gynecol. 1987;30(4):789–811.PubMedCrossRef
23.
WHO Study Group. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Geneva: World Health Organization; 1994.
24.
Kanis JA, Johnell O, Oden A, Johansson H, McCloskey E. FRAX and the assessment of fracture probability in men and women from the UK. Osteopor Int. 2008;19:385–97.CrossRef
25.
Maalouf G, Gannagé-Yared MH, Ezzedine J, Larijani B, Badawi S, Rached A, et al. Lebanese osteoporosis prevention society, Shariati hospital, Iran. Middle East and North Africa consensus on osteoporosis. J Musculoskelet Neuronal Interact. 2007;7:131–43.PubMed
26.
Rouzi AA, Al Sibiani SA, Al Senani NS, Radaddi RM, Aradawi MS. Independent predictors of all osteoporosis related fractures among healthy Saudi postmenopausal women: the CEOR study. Bone. 2012;50:713–22.PubMedCrossRef
27.
Moyad MA. Osteoporosis: a rapid review of risk factors and screening methods. Urol Oncol. 2003;21:375–9.PubMedCrossRef
28.
Sani FM, Sarji SA, Bilgen M. Quantitative ultrasound: measurement of the calcaneus in Southeast Asian children with thalassemia: comparison with dual-energy X-ray absorptiometry. J Ultrasound Med. 2011;30:883–94.PubMedCrossRef
29.
30.
Dawson-Hughes B, Tosteson AN, Melton L, Baim S, Favus MJ, Khosla S, et al. Implications of absolute fracture risk assessment for osteoporosis practice guidelines in the USA. Osteoporos Int. 2008;19(4):449–58.PubMedCrossRef
31.
32.
Riggs BL, Melton LJ, Robb RA, Camp JJ, Atkinson EJ, Peterson JM, et al. Population-based study of age and sex differences in bone volumetric density, size, geometry, and structure at different skeletal sites. J Bone Miner Res. 2004;19:1945–54.PubMedCrossRef
33.
Blake GM, Fogelman I. The clinical role of dual energy X-ray absorptiometry. Eur J Radiol. 2009;71:406–14.PubMedCrossRef
34.
35.
Goodpaster BH, Thaete FL, Kelley DE. Composition of skeletal muscle evaluated with computed tomography. Ann NY Acad Sci. 2000;904:18–24.PubMedCrossRef
36.
Pickhardt PJ, Lee LJ, Munoz del Rio A, Lauder T, Bruce RJ, Summers RM, et al. Simultaneous screening for osteoporosis at CT colonography: bone mineral density assessment using MDCT attenuation techniques compared with the DXA reference standard. J Bone Miner Res. 2011;26(9):2194–203.PubMedPubMedCentralCrossRef
37.
Summers RM, Baecher N, Yao J, Liu J, Pickhardt PJ, Choi JR, et al. Feasibility of simultaneous computed tomographic colonography and fully automated bone mineral densitometry in a single examination. J Comput Assist Tomogr. 2011;35:212–6.PubMedPubMedCentralCrossRef
38.
Rehman Q, Lang T, Modin G, Lane NE. Quantitative computed tomography of the lumbar spine, not dual X-ray absorptiometry, is an independent predictor of prevalent vertebral fractures in postmenopausal women with osteopenia receiving long-term glucocorticoid and hormone-replacement therapy. Arthritis Rheum. 2002;46:1292–7.PubMedCrossRef
39.
Jara H, Wehrli FW, Chung H-W, Ford JC. High resolution variable flip angle 3D MR imaging of trabecular microstructure in vivo. Magn Reson Med. 1993;29:528–39.PubMedCrossRef
40.
Majumdar S, Thomasson D, Shimakawa A, Genant HK. Quantitation of the susceptibility difference between trabecular bone and bone marrow: experimental studies. Magn Reson Med. 1991;22:111–27.PubMedCrossRef
41.
Ford JC, Wehrli FW, Chung H-W. Magnetic field distribution in models of trabecular bone. Magn Reson Med. 1993;30:373–9.PubMedCrossRef
42.
Wu Y, Ackerman JL, Chesler DA, Li J, Neer RM, Wang J, et al. Evaluation of bone mineral density using three-dimensional solid state phosphorus-31 NMR projection imaging. Calcif Tissue Int. 1998;62:512–8.PubMedCrossRef
43.
Anumula S, Wehrli SL, Magland J, Wright AC, Wehrli FW. Ultrashort echo-time MRI detects changes in bone mineralization and water content in OVX rat bone in response to alendronate treatment. Bone. 2010;46:1391–9.PubMedPubMedCentralCrossRef
44.
Majumdar S, Kothari M, Augat P, Newitt DC, Link TM, Lin JC, et al. High-resolution magnetic resonance imaging: three-dimensional trabecular bone architecture and biomechanical properties. Bone. 1998;22:445–54.PubMedCrossRef
45.
Wehrli FW, Song HK, Saha PK, Wright AC. Quantitative MRI for the assessment of bone structure and function. NMR Biomed. 2006;19:731–64.PubMedCrossRef
46.
Newitt DC, van Rietbergen B, Majumdar S. Processing and analysis of in vivo high-resolution MR images of trabecular bone for longitudinal studies: reproducibility of structural measures and micro-finite element analysis derived mechanical properties. Osteoporos Int. 2002;13(4):278–87.PubMedCrossRef
47.
Krieg MA, Barkmann R, Gonnelli S, Stewart A, Bauer DC, Del Rio Barquero L, et al. Quantitiative ultrasound in the management of osteoporosis: the 2007 ISCD official positions. J Clin Densitom. 2008;11:163–87.PubMedCrossRef
48.
Hans D, Dargent-Molina P, Schott AM, Serbert JL, Cormier C, Kotzki PO, et al. Ultrasonographic heel measurements to predict hip fracture in eldery women: the EPIDOS prospective study. Lancet. 1996;348:511–4.PubMedCrossRef
49.
Khaw KT, Reeve J, Luben R, Bingham S, Welch A, Wareham N, et al. Prediction of total and hip fracture risk in men and women by quantitative ultrasound of the calcaneus: EPIC-Norfolk prospective population study. Lancet. 2004;363:197–202.PubMedCrossRef
50.
Glüer CC, Wu CY, Jergas M, Goldstein SA, Genant HK. Three quantitative ultrasound parameters reflect bone structure. Calcif Tissue Int. 1994;55:46–52.PubMedCrossRef
51.
Vignolo M. Longitudinal assessment of bone quality by quantitative ultrasonography in children and adolescents. Ultrasound Med Biol. 2006;32:1003–10.PubMedCrossRef
52.
Sasso M, Haïat G, Yamato Y, Naili S, Matsukawa M. Dependence of ultrasonic attenuation on bone mass and microstructure in bovine cortical bone. J Biomech. 2008;41(2):347–55.PubMedCrossRef
53.
Guglielmi G, Njeh CF, de Terlizzi F, De Serio DA, Scillitani A, Cammisa M, et al. Phalangeal quantitative ultrasound, phalangeal morphometric variables, and vertebral fracture discrimination. Calcif Tissue Int. 2003;72(4):469–77.PubMedCrossRef
54.
Gonnelli S, Cepollaro C, Gennari L, Montagnani A, Caffarelli C, Merlotti D, et al. Quantitative ultrasound and dual-energy X-ray absorptiometry in the prediction of fragility fracture in men. Osteoporos Int. 2005;16:963–8.PubMedCrossRef
55.
Meszaros S, Toth E, Ferencz V, Csupor E, Hosszu E, Horvath C. Calcaneous quantitative ultrasound measurements predicts vertebral fractures in idiopathic male osteoporosis. Joint Bone Spine. 2007;74:79–84.PubMedCrossRef
56.
Ndongo S, Sutter B, Ka O, Diouf G, Diongue M, Kemta Lekpa F, et al. Quantitative ultrasound measurements at the calcaneus in a population of urban Senegalese women: least significant difference and T-score. Rheumatology. 2012;2(1):1–4.
57.
Rhee Y, Lee J, Jung JY, Lee JE, Park SY, Kim YM, et al. Modifications of T-scores by quantitative ultrasonography for the diagnosis of osteoporosis in Koreans. J Korean Med Sci. 2009;24:232–6.PubMedPubMedCentralCrossRef
58.
Cournil A, Eymard-Duverna S, Diouf A, Moque C, Coutherut J, Gueye NFN, et al. Reduced quantitative ultrasound bone mineral density in HIV-infected patients on antiretroviral therapy in Senegal. PLoS ONE. 2012;7(2):1–7.CrossRef
59.
Boskey AL, DiCarlo E, Paschalis E, West P, Mendelsohn R. Comparison of mineral quality and quantity in iliac crest biopsies from high- and low-turnover osteoporosis: an FT-IR microspectroscopic investigation. Osteoporos Int. 2005;16(12):2031–8.PubMedPubMedCentralCrossRef
60.
Szulc P, Delmas PD. Biochemical markers of bone turnover: potential use in the investigation and management of postmenopausal osteoporosis. Osteoporos Int. 2008;19:1683–704.PubMedCrossRef
61.
Deal CL. Using bone densitometry to monitor therapy in treating osteoporosis: pros and cons. Curr Rheumatol Rep. 2001;3:233–9.PubMedCrossRef
62.
Delmas PD, Eastell R, Garnero P, Seibel MJ, Stepan J. The use of biochemical markers of bone turnover in osteoporosis. Committee of scientific advisors of the international osteoporosis foundation. Osteoporos Int. 2000;11:S2–17.PubMedCrossRef
63.
Reginster J, Minne HW, Sorensen OH, Hooper M, Roux C, Brandi ML, et al. Randomized trial of the effects of risedronate on vertebral fractures in women with established postmenopausal osteoporosis. Vertebral efficacy with risedronate therapy (VERT) Study Group. Osteoporos Int. 2000;11:83–91.PubMedCrossRef
64.
Bjarnason NH, Christiansen C. Early response in biochemical markers predicts long-term response in bone mass during hormone replacement therapy in early postmenopausal women. Bone. 2000;26:561–9.PubMedCrossRef
65.
Vasikaran S, Eastell R, Bruyère O, Foldes AJ, Garnero P, Griesmacher A, et al. Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards. Osteoporos Int. 2011;22:391–420.PubMedCrossRef
66.
Lee J, Vasikaran S. Current recommendations for laboratory testing and use of bone turnover markers in management of osteoporosis. Ann Lab Med. 2012;32(2):105–12.PubMedPubMedCentralCrossRef
67.
Holick MF. Vitamin D status: measurement, interpretation and clinical application. Am Epidemil. 2009;19:73–8.
68.
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(7):1911–30.PubMedCrossRef
69.
Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B. Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr. 2006;84:18–28.PubMed
70.
Bishoff-Ferrari HA. How to select the doses of vitamin D in the management of osteoporosis. Osteoporos Int. 2007;18:401–7.CrossRef
71.
Holick MF, Chen TC. Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nutr. 2008;87:1080S–6S.PubMed
72.
Unger MD, Cuppari L, Titan SM, Magalhaes MCT, Sassaki AL, Reis LM, et al. Vitamin D status in a sunny country: where has the sun gone? Clin Nutr. 2010;29(6):784–8.PubMedCrossRef
73.
Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, et al. The 2011 report on dietary reference intakes for calcium and vitamin D from the institute of medicine: what clinicians need to know. J Clin Endocrinol Metab. 2011;96:53–8.PubMedCrossRef
74.
Holick MF. The vitamin D epidemic and its health consequences. J Nutr. 2005;135:2739S–48S.PubMed
75.
Maeda SS, Kunii IS, Hayashi LF, Lazaretti-Castro M. Increases in summer serum 25-hydroxyvitamin D (25(OH)D) concentrations in elderly subjects in Sao Paulo, Brazil vary with age, gender and ethnicity. BMC Endocr Disord. 2010;10:12.PubMedPubMedCentralCrossRef
76.
Bandeira F, Griz L, Freese E, Lima DC, The AC, Diniz ET, et al. Vitamin D deficiency and its relationship with bone mineral density among postmenopausal women living in the tropics. Arq Bras Endocrinol Metab. 2010;54(2):227–32.CrossRef
77.
Camargo MBR, Kunii IS, Fukusima Hayashi L, Muszkat P, Gusman Anelli C, Villa Marin-Mio R, et al. Modifiable factors of vitamin D status among a Brazilian osteoporotic population attended a public outpatient clinic. Arq Bras Endocrinol Metab. 2014;58(5):572–85.CrossRef
78.
Fuleihan GE, Nabulsi M, Tamin H, Maalouf J, Salamoun M, Khalife H, et al. Effect of vitamin D replacement on musculoskeletal parameters in school children: a randomized controlled trial. J Clin Endocrinol Metab. 2006;91(2):405–12.CrossRef
79.
Scalco R, Preamor MO, Froehlich PE, Furlanetto TW. High prevalence of hypovitaminosis and secondary hyperparathyroidism in elders living in nonprofit homes in South Brazil. Endocrine. 2008;33:95–100.PubMedCrossRef
80.
81.
Murray TM, Rao LG, Divieti P, Bringhurst FR. Parathyroid hormone secretion and action: evidence for discrete receptors for the carboxyl-terminal region and related biological actions of carboxyl-terminal ligands. Endocr Rev. 2005;26:78–113.PubMedCrossRef
82.
83.
Aspray TJ, Prentice A, Cole TJ, Sawo Y, Reeve J, Francis RM. Low bone mineral content is common but osteoporotic fractures are rare in eldery rural Gambian women. J Bone Miner Res. 1996;11:1019–25.PubMedCrossRef
84.
Vanderjagt DJ, Bond B, Dulai R, Pickel A, Ujah IO, Wadinga WW, et al. Assessment of the bone status of Nigerian women by ultrasound and biochemical markers. Calcif Tissue Int. 2001;68:277–84.PubMedCrossRef
85.
Zebaze RM, Seeman E. Epidemiollogy of hip and wrist fractures in Cameroon, Africa. Ostopor Int. 2003;14:301–5.CrossRef
86.
Grinspoon S, Carr A. Cardiovascular risk and body-fat abnormalities in HIV-infected adults. N Eng J Med. 2005;352:48–62.CrossRef
87.
Samaras K. Prevalence and pathogenesis of diabetes mellitus in HIV-1 infection treated with combined antiretroviral therapy. J Acquar Immune Defic Syndr. 2009;50:499–505.CrossRef
88.
Hadigan C, Kamin D, Liebau J, Mazza S, Barrow S, Torriani M, et al. Depot-specific regulation of glucose uptake and insulin sensitivity in HIV-lipodystrophy. Am J Physiol Endocrinol Metab. 2006;290:E289–98.PubMedCrossRef
89.
Gilsanz V, Chalfant J, Mo AO, Lee DC, Dorey FJ, Mittelman SD. Reciprocal relations of subcutaneous and visceral fat to bone structure and strength. J Clin Endocrinol Metab. 2009;94(9):3387–93.PubMedPubMedCentralCrossRef
90.
Russel M, Mendes N, Miller KK, Rosen CJ, Lee H, Klibanski A, et al. Visceral fat is a negative predictor of bone density measures in obese adolescent girls. J Clin Endocrinol Metab. 2010;95:1247–55.CrossRef
91.
Yamaguchi T, Kanazawa I, Yamamoto M, Kurioka S, Yamauchi M, Yano S, et al. Associations between components of the metabolic syndrome versus bone mineral density and vertebral fractures in patients with type 2 diabetes. Bone. 2009;45:174–9.PubMedCrossRef
92.
Bredella MA, Tirruabu M, Ghomi RH, Thomas BJ, Brick DJ, Gerweck AV, et al. Determinants of bone mineral density in obese premenopausal women. Bone. 2011;48:748–54.PubMedCrossRef
93.
Adami S, Zivelonghi A, Braga V, Fracassi E, Gatti D, Rossini M, et al. Insulin-like growth factor-1 is associated with bone formation markers, PTH and bone mineral density in healthy premenopausal women. Bone. 2010;46:244–7.PubMedCrossRef
94.
95.
Utz AI, Yamamoto A, Hemphill L, Miller KK. Growth hormone deficiency by growth hormone releasing hormone-arginine testing criteria predicts increased cardiovascular risk markers in normal young overweight and obese women. J Clin Endocrinol Metab. 2008;93:2507–14.PubMedPubMedCentralCrossRef
96.
Cartier A, Lemieux I, Almeras N, Tremblay A, Bergeron J, Despres JP. Visceral obesity and plasma glucose-insulin homeostasis: contributions of interleukin-6 and tumour necrosis factor-alpha in men. J Clin Endocrinol Metab. 2008;93:1931–8.PubMedCrossRef
97.
Pou KM, Massaro JM, Hoffmann U, Vasan RS, Maurovich-Horvat P, Larson MG, et al. Visceral and subcutaneous adipose tissue volumes are cross-sectionally related to markers of inflammation and oxidative stress: the Framingham Heart Study. Circ. 2007;116:1234–41.CrossRef
98.
Lu LJ, Nayeem F, Anderson KE, Grady JJ, Nagamani M. Lean body mass, not estrogen or progesterone, predicts peak bone mineral density in premenopausal women. J Nutr. 2009;139:250–6.PubMedPubMedCentralCrossRef
99.
Do Prado WL, de Piano A, Lazaretti-Castro M, de Mello MT, Stella SG, Tufik S, et al. Relationship between bone mineral density, leptin and insulin concentration in Brazillian obese adolescents. J Bone Miner Metab. 2009;27:613–9.PubMedCrossRef
100.
Ferron M, Lacombe J. Regulation of energy metabolism by the skeleton: osteocalcin and beyond. Arch Biochem Biophys. 2014;561:137–46.PubMedCrossRef
101.
Upadhyay J, Farr OM, Mantzoros CS. The role of leptin in regulating bone metabolism. Metabolism. 2015;64(1):105–13.PubMedCrossRef
102.
Weinberg ME, Lo JC, Grunfeld C, Schambelan M. Endocrine complications of HIV infection. In: Volberding PA, Sande MA, Greene WC, Lange JMA, Gallant JE, editors. Global HIV/AIDS medicine. New York: Saunders Elsevier; 2008. p. 287–98.CrossRef
103.
Shashidhar PK, Shashikala GV. Low dose adrenocorticotropic hormone test and adrenal insufficiency in critically ill acquired immunodeficiency syndrome patients. Indian J Endocrinol Metab. 2012;16:389–94.PubMedPubMedCentralCrossRef
104.
Lindsay R, Cosman F. Osteoporosis. In: Braunwald E, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL, editors. Harrison’s 15th edition: principles of internal medicine, vol. 2. USA: McGraw-Hill; 2001. p. 2226–37.
105.
Gennari L, Merlotti D, De Paola V, Calabro A, Becherini L, Martini G, et al. Estrogen receptor gene polymorphisms and the genetics of osteoporosis: a huge review. Am J Epidemiol. 2005;161:307–20.PubMedCrossRef
106.
107.
Kojic EM, Wang CC, Cu-Uvin S. HIV and menopause: a review. J Womens Health (Larchmt). 2007;16(10):1402–11.CrossRef
108.
Valdiglesias V, Sanchez-Flores M, Maseda A, Marcos-Perez D, Millan-Calenti JC, Pasaro E, et al. Lymphocyte subsets in a population of nonfrail elderly individuals. J Toxicol Environ Health A. 2015;78(13–14):790–804.PubMedCrossRef
109.
110.
Ohlsson C, Vandenput LV. The role of estrogens for male bone health. Eur J Endocrin. 2009;160(6):883–9.CrossRef
111.
Burnett-Bowie SA, McKay EA, Lee H, Leder BZ. Effects of aromatase inhibition on bone mineral density and bone turnover in older men with low testosterone levels. J Clin Endocrinol Metab. 2009;94:4785–92.PubMedPubMedCentralCrossRef
112.
Sorgren K, Lagerquist M, Moverare-Skrtic S, Andersson N, Windahl SH, Swanson C, et al. Elevated aromatase expression in osteoblasts leads to increased bone mass without systemic adverse effects. J Bone Miner Res. 2009;24:1263–70.CrossRef
113.
Katznelson L, Finkelstein JS, Schoenfeld DA, Rosenthal DI, Anderson EJ, Klibanski A. Increase in bone density and lean body mass during testosterone administration in men with acquired hypogonadism. J Clin Endocrinol Metab. 1996;81(12):4358–65.PubMed
114.
115.
Falahati-Nini A, Riggs BL, Atkinson EJ, O’Fallon WM, Eastell R, Khosla S. Relative contributions of testosterone and estrogen in regulating bone resorption and formation in normal elderly men. J Clin Invest. 2000;106(12):1553–60.PubMedPubMedCentralCrossRef
116.
Rochira V, Balestrieri A, Madeo B, Zirilli L, Granata AR, Carani C. Osteoporosis and male age-related hypogonadism: role of sex steroids on bone (patho)physiology. Eur J Endocrinol. 2006;154(2):175–85.PubMedCrossRef
117.
Santi D, Madeo B, Carli F, Zona S, Brigante G, Vescini F, et al. Serum total estradiol, but not testosterone is associated with reduced bone mineral density (BMD) in HIV-infected men: a cross-sectional, observational study. Osteopor Int. 2016;27(3):1103–14.CrossRef
118.
Rochira V, Zirilli L, Orlando G, Santi D, Brigante G, Diazzi C, et al. Premature decline of serum total testosterone in HIV-infected men in the HAART-era. PLoS ONE. 2011;6(12):e28512.PubMedPubMedCentralCrossRef
119.
Short CE, Shaw SG, Fisher MJ, Walker-Bone K, Gilleece YC. Prevalence of and risk factors for osteoporosis and fracture among a male HIV-infected population in the UK. Int J STD AIDS. 2014;25(2):113–21.PubMedCrossRef
120.
Pepe J, Isidori AM, Falciano M, Iaiani G, Salotti A, Diacinti D, et al. The combination of FRAX and ageing male symptoms scale better identifies treated HIV males at risk for major fracture. Clin Endocrinol (Oxf). 2012;77(5):672–8.CrossRef
121.
Pepe J, Isidori AM, Falciano M, Iaiani G, Salotti A, Diacinti D, et al. Effect of risedronate in osteoporotic HIV males according to gonadal status: a pilot study. Endodrine. 2014;47(2):456–62.
122.
Inrig JK, Szczech LA, Gerntholtz TE, Klotman PE. Renal complications of HIV infection. In: Volberding PA, Sande MA, Greene WC, Lange JMA, editors. Global HIV/AIDS medicine. New York: Saunders Elsevier; 2008. p. 299–307.CrossRef
123.
Nelson MA, Katlama C, Montaner J, Cooper DA, Gazzard B, Clotet B, et al. The safety of tenofovir disoproxil fumarate for the treatment of HIV infection in adults: the first 4 years. AIDS. 2007;21:1273–81.PubMedCrossRef
124.
Fux CA, Christen A, Zgaggen S, Mohaupt MG, Furrer H. Effect of tenofovir on renal glomerular and tubular function. AIDS. 2007;21:1483–5.PubMedCrossRef
125.
Karras A, Lafaurie M, Furco A, Bourgarit A, Droz D, Sereni D, et al. Tenofovir-related nephrotoxicity in human immunodeficiency virus-infected patients: three cases of renal failure, Fanconi syndrome, and nephrogenic diabetes insioidus. Clin Infect Dis. 2003;36:1070–3.PubMedCrossRef
126.
Peyriere H, Reynes J, Rouanet I, Daniel N, De Boever CM, Mauboussin JM, et al. Renal tubular dysfunction associated with tenofovir therapy: report on 7 cases. J Acquar Immune Defic Syndr. 2004;35:269–73.CrossRef
127.
Cooper RD, Wiebe N, Smith N, Keiser P, Naicker S, Tonelli M. Systematic review and meta-analysis: renal safety of tenofovir disoproxil fumurate in HIV-infected patients. Clin Infect Dis. 2010;51:496–505.PubMedCrossRef
128.
Smith KY, Patel P, Fine D, Bellos N, Sloan I, Lackey P, et al. Randomized, double-blind, placebo-matched, multicenter trial of abacavir/lamivudine or tenofovir/emiricitabine with lopinavir/ritonavir for initial HIV treatment. AIDS. 2009;23:1547–56.PubMedCrossRef
129.
Martinez E, Arranz JA, Podzameczer D, Lonca M, Sanz J, Barragán P, et al. A simplification trial switching from nucleoside reverse transcriptase inhibitors to once-daily fixed-dose abacavir/lamuvidine or tenofovir/emtricitabine in HIV-1-infected patients with virological supression. J Acquir Immune Defic Syndr. 2009;51:290–7.PubMedCrossRef
130.
Post FA, Moyle GJ, Stellbrink HJ, Domingo P, Podzameczer D, Fisher M, et al. Randomized comparison of renal effects, efficacy, and safety with once-daily abacavir/lamivudine versus tenofovir/emtricitabine, administered with efavirenz, in antiretroviral-naive, HIV-1-infected adults: 48-week results from the ASSERT study. J Acquir Immune Defic Syndr. 2010;55:49–57.PubMedCrossRef
131.
Martin A, Bloch M, Amin J, Baker D, Cooper DA, Emery S, et al. Simplification of antiretroviral therapy with tenofovir-emtricitabine or abacavir-lamivudine: a randomized, 96-week trial. Clin Infect Dis. 2009;49:1591–601.PubMedCrossRef
132.
Rasmussen TA, Jensen D, Tolstrup M, Nielsen US, Erlandsen EJ, Birn H, et al. Comparison of bone and renal effects in HIV-infected adults switching to Abacavir or Tenofovir based therapy in a randomized trial. PLoS ONE. 2012;7(3):e32445.PubMedPubMedCentralCrossRef
133.
DeJesus E, Haas B, Segal-Maurer S, Ramgopal M, Mills A, Liu Y, et al. Superior efficacy and improved renal and bone safety after switching from a tenofovir disoproxil fumarate (TDF) regimen to a tenofovir alafenamide (TAF) based regimen through 96 weeks (W96) of treatment. Paper presented at: Boston: ASM Microbe; 2016.
134.
Mills A, Crofoot GJ, McDonald C, Shalit P, Flamm JA, Gathe JJ, et al. Tenofovir alafenamide versus tenofovir disoproxil fumarate in the first protease inhibitor-based single-tablet regimen for initial HIV-1 therapy: a randomized phase 2 study. J Acquir Immune Defic Syndr. 2015;69(4):439–45.PubMedCrossRef
135.
Raffi F, Orkin C, Clarke A, Slama L, Gallant J, Daar E, et al. Brief report: long-term (96-week) efficacy and safety after switching from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF) in HIV-infected, virologically suppressed adults. J Acquir Immune Defic Syndr. 2017;75:226–31.PubMedPubMedCentralCrossRef
136.
Arribas JR, Thompson M, Sax P, Haas B, McDonald C, Wohl D, et al. Significant efficacy and long-term safety difference with TAF-based STR in naive adults. Paper presented at: Seattle: Retroviruses and Opportunistic Infections (CROI); 2017.
137.
Brown T, Yin MT, Gupta S, Katlama C, Lazzarin A, Melbourne K, et al. Switching from TDF to TAF in HIV-infected adults with low BMD: a pooled analysis. Paper presented at: Seattle: Retroviruses and Opportunistic Infections (CROI); 2017.
138.
Cazanave C, Dupon M, Lavignolle-Aurillac V, Barthe N, Lawson-Ayayi S, Mehsen N, et al. Reduced bone mineral density in HIV-infected patients: prevalence and associated factors. AIDS. 2008;22(3):395–402.PubMedCrossRef
139.
Rivas P, Górgolas M, García-Delgado R, Díaz-Curiel M, Goyenechea A, Fernández-Guerrero ML. Evolution of bone mineral density in AIDS patients on treatment with zidovudine/lamivudine plus abacavir or lopinavir/ritonavir. HIV Med. 2008;9(2):89–95.PubMedCrossRef
140.
Jones S, Restrepo D, Kasowitz A, Korenstein D, Wallenstein S, Schneider A, et al. Risk factors for decreased bone density and effects of HIV on bone in the eldery. Osteopor Int. 2008;19(7):913–8.CrossRef
141.
Dolan SE, Carpenter S, Grinspoon S. Effects of weight, body composition, and testosterone on bone mineral density in HIV-infected women. J Acquir Immune Defic Syndr. 2007;45(2):161–7.PubMedCrossRef
142.
Brown TT, Qaqish RB. Antiretroviral therapy and the prevalence of osteopenia and osteoporosis: a meta-analytical review. AIDS. 2006;20:2165–74.PubMedCrossRef
143.
McComsey GA, Teba P, Shane E, Yin MT, Overton ET, Huang JS, et al. Bone disease in HIV infection: a practical review and recommendations for HIV care providers. Clin Infect Dis. 2010;51:937–46.PubMedPubMedCentralCrossRef
144.
Triant VA, Brown TT, Lee H, Grinspoon SK. Fracture prevalence among human immunodeficiency virus (HIV)-infected versus non-HIV-infected patients in a large U.S. healthcare system. J Clin Endocrinol Metab. 2008;93(9):3499–504.PubMedPubMedCentralCrossRef
145.
Bonjoch A, Figueras M, Estany C, Perez-Alvarez N, Rosales J, del Rio L, et al. High prevalence of and progression to low bone mineral density in HIV-infected patients: a longitudinal cohort study. AIDS. 2010;24:2827–33.PubMedCrossRef
146.
Sharma A, Flom PL, Weedon J, Klein RS. Prospective study of bone mineral density changes in aging men with or at risk for HIV infection. AIDS. 2010;24(15):2337–45.PubMedPubMedCentral
147.
Bolland MJ, Grey A. HIV and low bone density: responsible party, or guilty by association? IBMS BoneKEy. 2011;8:7–15.CrossRef
148.
Borderi M, Gibellini D, Vescini F, De Crignis E, Cimatti L, Biagetti C, et al. Metabolic bone disease in HIV infection. AIDS. 2009;23:1297–310.PubMedCrossRef
149.
Duvivier C, Kolta S, Assoumou L, Ghosn J, Rozenberg S, Murphy RL, et al. Greater decrease in bone mineral density with protease inhibitor regimens in HIV-1 infected naïve patients. AIDS. 2009;23:817–24.PubMedCrossRef
150.
Gibellini D, de Crignis E, Ponti C, Cimatti L, Borderi M, Tschon M, et al. HIV-1 triggers apoptosis in primary osteoblasts and HOBIT cells through TNF-alpha activation. J Med Virol. 2008;80(9):1507–14.PubMedCrossRef
151.
Rodriquez M, Daniels B, Gunawardene S, Robbins GK. High frequency of vitamin D deficiency in ambulatory HIV-positive patients. AIDS Res Hum Retroviruses. 2009;25(1):9–14.CrossRef
152.
Teichmann J, Lange U, Discher T, Lohmeyer J, Stracke H, Bretzel RG. Bone mineral density in human immunodeficiency virus-1 infected men with hypogonadism prior to highly-active-antiretroviral-therapy (HAART). Eur J Med Res. 2009;14(2):59–64.PubMedPubMedCentralCrossRef
153.
Weitzmann MN. The role of inflammatory cytokines, the RANKL/OPG axis, and the immunoskeletal interface in physiological bone turnover and osteoporosis. Scientifica. 2013;2013:29.CrossRef
154.
Vikulina T, Fan X, Yamaguchi M, Roser-Page S, Zayzafoon M, Guidot DM, et al. Alterations in the immuno-skeletal interface drive bone destruction in HIV-1 transgenic rats. Proc Natl Acad Sci USA. 2010;107(31):13848–53.PubMedPubMedCentralCrossRef
155.
156.
Moir S, Ho J, Malaspina A, Wang W, Dipoto AC, O’Shea MA, et al. Evidence for HIV-associated B cell exhaustion in a dysfunctional memory B cell compartment in HIV-infected viremic individuals. J Exp Med. 2008;205(8):1797–805.PubMedPubMedCentralCrossRef
157.
Hittinger G, Poggi C, Delbeke E, Pronfizi N, Lafeuillade A. Correlation between plasma levels of cytokines and HIV-1 RNA copy number in HIV-infected patients. Infection. 1998;26:100–3.PubMedCrossRef
158.
Chakravarti A, Marceau AA, Flamand L, Poubelle PE. Normal human primary CD4+ T lymphocytes synthesize and release functional osteoprotegerin in vitro. Lab Invest. 2008;88(2):171–84.PubMedCrossRef
159.
Dolan SE, Kanter JR, Grinspoon S. Longitudinal analysis of bone density in human immunodeficiency virus-infected women. J Clin Endocrinol Metab. 2006;91(8):2938–45.PubMedPubMedCentralCrossRef
160.
Stellbrink HJ, Orkin C, Arribas JR, Compston J, Gerstoft J, Van Wijngaerden E, et al. Comparison of changes in bone density and turnover with abacavir-lamivudine versus tenofovir-emtricitabine in HIV-infected adults: 48-week results from ASSERT study. Clin Infect Dis. 2010;51:963–72.PubMedCrossRef
161.
Brown TT, Ross AC, Storer N, Labbato D, McComsey GA. Bone turnover, osteoprotegerin/RANKL and inflammation with antiretroviral initiation: tenofovir versus non-tenofovir regimens. Antivir Ther. 2011;16(7):1063–72.PubMedCrossRef
162.
Tijani K, Vunnava A, Sheth AN, Delille C, Lennox JL, Sanford SE, et al. Dysregulated B cell expression of RANKL and OPG correlates with loss of bone mineral density in HIV infection. PLoS Pathog. 2014;10(11):e1004497.CrossRef
163.
Gibellini D, Borderi M, De Crignis E, Cicola R, Vescini F, Caudarella R, et al. RANKL/OPG/TRAIL plasma levels and bone mass loss evaluation in antiretroviral naïve HIV-1-positive men. J Med Virol. 2007;79:1446–54.PubMedCrossRef
164.
Ueland T, Bollerslev J, Godang K, Müller F, Frøland SS, Aukrust P. Increased serum osteoprotegerin in disorders characterized by persistent immune activation or glucocorticoid excess-possible role in bone homeostasis. Eur J Endocrinol. 2001;145:685–90.PubMedCrossRef
165.
Gao Y, Grassi F, Ryan MR, Terauchi M, Page K, Yang X, et al. IFN-gamma stimulates osteoclast formation and bone loss in vivo via antigen-driven T cell activation. J Clin Invest. 2007;117(1):122–32.PubMedCrossRef
166.
Takayanagi H, Ogasawara K, Hida S, Chiba T, Murata S, Satp K, et al. T-cell-mediated regulation of osteoclastogenesis by signalling cross-talk between RANKL and IFN-γ. Nature. 2000;408(6812):600–5.PubMedCrossRef
167.
Brown TT, McComsey GA, King MS, Qaqish RB, Bernstein BM, da Silva BA. Loss of bone mineral density after antiretroviral therapy initiation, independent of antiretroviral regimen. J Acquir Immune Defic Syndr. 2009;51:554–61.PubMedCrossRef
168.
Gallant JE, Staszewski S, Pozniak AL, DeJesus E, Suleiman JM, Miller MD, et al. Efficacy and safety of tenofovir DF vs stavudine in combination therapy in antiretroviral-naïve patients: a 3-year randomized trial. JAMA. 2004;292:191–201.PubMedCrossRef
169.
Finkelstein JS, Brockwell SE, Mehta V, Greendale GA, Sowers MR, Ettinger B, et al. Bone mineral density changes during the menopause transition in a multi-ethnic cohort of women. J Clin Endocrinol Metab. 2008;93(3):861–8.PubMedCrossRef
170.
McComsey GA, Kitch D, Daar ES, Tierney C, Jahed NC, Tebas P, et al. Bone mineral density and fractures in antiretroviral-naive persons randomized to receive abacavir-lamivudine or tenofovir disoproxil fumarate-emtricitabine along with efavirenz or atazanavir-ritonavir: aids clinical trials group A5224s, a substudy of ACTG A5202. J Infect Dis. 2011;203:1791–801.PubMedPubMedCentralCrossRef
171.
Cotter AG, Powderly WG. Endocrine complications of human immunodeficiency virus infection: hypogonadism, bone disease and tenofovir-related toxicity. Best Pract Res Clin Endocrinol Metab. 2011;25:501–15.PubMedCrossRef
172.
Moyle GJ, Stellbrink HJ, Compston J, Orkin C, Arribas JR, Domingo P, et al. 96-week results of abacavir/lamivudine versus tenofovir/emtricitabine, plus efavirenz, in antiretroviral-naïve, HIV-1-infected adults: ASSERT study. Antivir Ther. 2013;18(7):905–13.PubMedCrossRef
173.
Giacomet V, Mora S, Martelli L, Merlo M, Sciannanblo M, Vigano A. A 12-month treatment with tenofovir does not impair bone mineral accrual in HIV-infected children. J Acquir Immune Defic Syndr. 2005;40:448–50.PubMedCrossRef
174.
Vigano A, Zuccotti GV, Puzzovio M, Pivetti V, Zamproni I, Cerini C, et al. Tenofovir disoproxil fumarate and bone mineral density: a 60-month longitudinal study in a cohort of HIV-infected youths. Antivir Ther. 2010;15:1053–8.PubMedCrossRef
175.
Carr A, Miller J, Eisman JA, Cooper DA. Osteopenia in HIV-infected men: association with asymptomatic lactic acidemia and lower weight pre-antiretroviral therapy. AIDS. 2001;15:703–9.PubMedCrossRef
176.
Calmy A, Fux CA, Norris R, Vallier N, Delhumeau C, Samaras K, et al. Low bone mineral density, renal dysfunction and fracture risk in HIV-infection: a cross-sectional study. J Infect Dis. 2009;200:1746–54.PubMedCrossRef
177.
Arnsten JH, Freeman R, Howard AA, Floris-Moore M, Santoro N, Schoenbaum EE. HIV infection and bone mineral density in middle-aged women. J Clin Infect Dis. 2006;42:1014–20.CrossRef
178.
Bruera D, Luna N, David DO, Bergoglio LM, Zamudio J. Decreased bone mineral density in HIV-infected patients is independent of antiretroviral therapy. AIDS. 2003;17:1917–23.PubMedCrossRef
179.
Amiel C, Ostertag A, Slama L, Baudoin C, N’Guyen T, Lajeunie E, et al. BMD is reduced in HIV-infected men irrespective of treatment. J Bone Miner Res. 2004;19:402–9.PubMedCrossRef
180.
Kinai E, Nishijima T, Mizushima D, Watanabe K, Aoki T, Honda H, et al. Long-term use of protease inhibitors is associated with bone mineral density loss. AIDS Res Hum Retroviruses. 2014;30(6):553–9.PubMedCrossRef
181.
Gibellini D, Borderi M, de Crignis E, Clo A, Miserocchi A, Viale P, et al. Analysis of the effects of specific protease inhibitors on OPG/RANKL regulation in an osteoblast-like cell line. New Microbiol. 2010;33:109–15.PubMed
182.
Modarresi R, Xiang Z, Yin M, Laurence J. WNT/β-catenin signalling is involved in regulation of osteoclast differentiation by human immunodeficiency virus protease inhibitor ritonavir. Am J Pathol. 2009;174:123–35.PubMedPubMedCentralCrossRef
183.
Santiago F, Oguma J, Brown AMC, Laurence J. Noncanonical Wnt signalling promotes osteoclast differentiation and is facilitated by the human immunodeficiency virus protease inhibitor ritonavir. Biochem Biophys Res Commun. 2012;417:223–30.PubMedCrossRef
184.
Yin MT, Modaressi R, Shane E, Santiago F, Ferris DC, McMahon DJ, et al. Efects of HIV-infection and antiretroviral therapy with ritonavir on induction of osteoclast-like cells in postmenopausal women. Osteopor Int. 2011;22:1459–68.CrossRef
185.
Hansen AB, Obel N, Nielsen H, Pedersen C, Gerstoft J. Bone mineral density changes in protease inhibitor-sparing vs. nucleoside reverse transcriptase inhibitor-sparing highly active antiretroviral therapy: data from a randomized trial. HIV Med. 2011;12(3):157–65.PubMedCrossRef
186.
Grant PM, Kitch D, McComsey GA, Dube MP, Haubrich R, Huang J, et al. Low baseline CD4+ cell count is associated with greater bone mineral density loss after ART initiation. Clin Infect Dis. 2013;57(10):1483–8.PubMedPubMedCentralCrossRef
187.
Wang MW, Wei S, Faccio R, Takeshita S, Tebas P, Powderly WG, et al. The HIV protease inhibitor ritonavir blocks osteoclastogenesis and function by impairing RANKL-induced signaling. J Clin Invest. 2004;114(2):206–13.PubMedPubMedCentralCrossRef
188.
Taylor A, Rogers M. HIV treatments and the skeleton: do NRTIs directly affect bone cells? Bone. 2010;46(1):S56.
189.
Ozçakar L, Guven GS, Unal S, Akinci A. Osteoporosis in Turkish HIV/AIDS patients: comparative analysis by dual energy X-ray absorptiometry and digital X-ray radiogrammetry. Osteoporos Int. 2005;16:1363–7.PubMedCrossRef
190.
Bakker I, Twisk JW, Mechelen WV, Kemper HC. Fat-free body mass is the most important body composition determinant of 10-yr longitudinal development of lumbar bone in adult men and women. J Clin Endocrinol Metab. 2003;88:2607–13.PubMedCrossRef
191.
192.
Schtscherbyna A, Pinheiro MF, de Mendonça LM, Gouveia C, Luiz RR, Machado ES, de Farias ML, et al. Factors associated with low bone mineral density in a Brazilian cohort of vertically HIV-infected adolescents. Int J Infect Dis. 2012;16:e872–8.PubMedCrossRef
193.
Duran AC, Almeida LB, Segurado AA, Jaime PC. Diet quality of persons living with HIV/AIDS on highly active antiretroviral therapy. J Hum Nutr Diet. 2008;21:346–50.PubMedCrossRef
194.
Peters BS, Dos Santos LC, Fisberg M, Wood RJ, Martini LA. Prevalence of vitamin D insufficiency in Brazilian adolescents. Ann Nutr Metab. 2009;54:15–21.PubMedCrossRef
195.
Silva HG, Tortora RP, Farias ML. Increased bone turnover during the third trimester of pregnancy and decreased bone mineral density after parturition in adolescents as compared to age-matched control patients. Gynecol Endocrinol. 2005;21:174–9.PubMedCrossRef
196.
Pollock E, Klotsas AE, Compston J, Gkrania-Klotsas E. Bone health in HIV infection. Br Med Bull. 2009;92:123–33.PubMedCrossRef
Metadata
Title
Bone mineral density in people living with HIV: a narrative review of the literature
Authors
M. J. Kruger
T. A. Nell
Publication date
01-12-2017
Publisher
BioMed Central
Published in
AIDS Research and Therapy / Issue 1/2017
Electronic ISSN: 1742-6405
DOI
https://doi.org/10.1186/s12981-017-0162-y

Other articles of this Issue 1/2017

AIDS Research and Therapy 1/2017 Go to the issue

Review

Evasion of adaptive immunity by HIV through the action of host APOBEC3G/F enzymes

Research

Effect of Moringa oleifera Lam. leaf powder on the pharmacokinetics of nevirapine in HIV-infected adults: a one sequence cross-over study

Research

HIV-1 drug-resistant mutations and related risk factors among HIV-1-positive individuals experiencing treatment failure in Hebei Province, China

Editorial

HIV vaccine research in Canada

Review

Killed whole-HIV vaccine; employing a well established strategy for antiviral vaccines

Review

Unlocking HIV-1 Env: implications for antibody attack

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits