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What exactly does antiretroviral therapy do to
bone? Plenary on Bone at CROI By Paddy Mallon
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Reported by Jules Levin
CROI 2016 Feb 22-24 Boston
Dr Paddy Mallon
UCD HIV Molecular Research Group
Associate Dean for Research and Innovation
UCD School of Medicine
Download the PDF here
"BMD loss with ART initiation is avoidable"
"BMD loss with ART initiation is avoidable
......."as the field develops and matures & we get more data I think what we need to do is implement these kinds of interventions".....age is the most important factor and across the globe patients are getting older
......HIV, ART, host factors, immune system, artifact due to VAT/body fat increase, ARTS: TDF, PIs, integrase, Strategies to avoid bone loss: interventions: Vit D/calcium supplementation....Zoledronic acid: BMD loss with ART initiation is avoidable!.......Alendronate for Prevention of ART-associated Bone Loss (APART) Study......
CROI: Single Dose Zoledronic Acid Prevents Antiretroviral-Induced Bone Loss - (02/24/16)
Bone Loss in HIV Persists Through Chronic Infection for Years - (02/16/16)
WEBCAST:http://www.croiwebcasts.org/console/player/29685?mediaType=audio&
"overall most centers report only a limited experience of fractures".....[from Jules: this is putting it mildly, there is little recognition globally that bone & fractures are a big concern now & certainly in the future with the aging population, frailty, cognitive impairment & bone fragility in HIV is resulting in increased fractures rates in HIV+ vs HIV-neg, fractures in older people result in increased mortality, and is an important patient issue apparently by this survey not being dealt with very well.]
"with only one centre (USA) reporting significant fragility fractures. It is notable, however, that this clinic population also has one of the highest proportions of both older patients (56% over 50 years old) and postmenopausal women (53%) of any of the centers contributing perspectives. (Hopkins)
Although these perspectives are limited by their reliance on both expert opinion and data, several key limitations in approaches to screening of bone health PLWH were identified that could be addressed through international consensus guidelines. Such guidelines could provide the basis for policies to preserve bone health in PLWH.
According to national surveys and local cohort studies, the estimated proportions of PLWH under care aged over 50 years was higher in North America, South America, Europe, and Australia compared with Asia and Africa, with numbers ranging from 35 to 56% and 11 to 17%, respectively. Similarly, data on the proportion of women with HIV either over 50 or postmenopausal was highest in the United States (53%) followed by Germany (30%) and Ireland (24%), and much lower in other countries, ranging from 1 to 16%"
Bone Loss in HIV Persists Through Chronic Infection for Years - (02/16/16)
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