Osteoporosis and osteopenia are not associated with T-cell activation in older cART-treated HIV-infected patients

M. Krikke*, R. C.W. Klomberg, E. van der Veer, K. T. Tesselaar, H. J. J. Verhaar, A. I. M. Hoepelman, J. E. Arends

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)

Abstract

Background: A higher risk of developing osteopenia/ osteoporosis has been seen in HIV-infected patients. We compared HIV-infected patients, all treated with combination antiretroviral therapy (cART), with a low bone mineral density (BMD) (T-score <-1) to those with a normal BMD (T-score > -1), examining the relation with T-cell activation and bone turnover markers (c-terminal telopeptide (CTX) and procollagen type 1 amino-terminal propeptide (P1NP)). Methods: In this single visit pilot study, bone turnover markers, T-cell activation (CD38 + HLA – DR +) and senescence (CD57+) of T cells were measured in patients who had previously undergone dual energy X-ray absorptiometry scanning. Results: All study participants (n = 16) were male, on cART, with a median age of 61 years (IQR 56-66). Nine patients had osteopenia/osteoporosis. When comparing the patients with osteopenia/osteoporosis with those with a normal BMD, no differences in activation and senescence were found. A relation was seen between higher bone formation (P1NP) and patients who were on cART for longer. The median length of cART use was 5.5 years (IQR 4.5-7.8), with all patients on nucleoside reverse transcriptase inhibitors, 88% on tenofovir, 63% on non-nucleoside reverse transcriptase inhibitors (NNRTIs) and 38% on protease inhibitors. Osteopenia/osteoporosis was seen in 100% of the patients on protease inhibitors versus 30% of those on NNRTIs. Conclusion: This study did not find an association between activated T cells and BMD, thus did not explain the higher prevalence of osteopenia/osteoporosis in HIV-infected patients. Interestingly, this small pilot showed that cART might influence BMD, with a possible negative effect for protease inhibitors and a possible protective effect for NNRTIs. These results warrant further investigation.

Original languageEnglish
Pages (from-to)138-144
Number of pages7
JournalNetherlands Journal of Medicine
Volume75
Issue number4
Publication statusPublished - May 2017

Keywords

  • Bone turnover markers
  • Combination antiretroviral therapy
  • HIV-infection
  • Immune activation
  • Osteoporosis
  • T-cell activation

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