Nevirapine Use Is Associated with Higher Bone Mineral Density in HIV-1 Positive Subjects on Long-Term Antiretroviral Therapy.

Publisher: Mary Ann Liebert Country of Publication: United States NLM ID: 8709376 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1931-8405 (Electronic) Linking ISSN: 08892229 NLM ISO Abbreviation: AIDS Res Hum Retroviruses Subsets: MEDLINE

Publication: Larchmont, NY : Mary Ann Liebert
Original Publication: [New York] : Mary Ann Liebert, [c1987-

Bone Density/*drug effects ; HIV Infections/*drug therapy ; Nevirapine/*therapeutic use ; Reverse Transcriptase Inhibitors/*therapeutic use; Absorptiometry, Photon ; Adult ; Cross-Sectional Studies ; Female ; Follow-Up Studies ; HIV Infections/complications ; HIV-1/drug effects ; Humans ; Male ; Middle Aged ; Prospective Studies ; Time Factors

We assessed bone mineral density (BMD) in a cohort of human immunodeficiency virus (HIV)-positive patients after a median of 11 years of combination antiretroviral therapy (cART) and evaluated the respective role of HIV infection and antiretroviral drugs (ARVs). A cross-sectional study of 162 participants (131 male) from the ANRS-C08 cohort was performed with bone dual-energy X-ray absorptiometry (DXA) scans and renal assessment. The window of exposure to ARVs was defined as an exposure of more than six cumulative months during the last 3 years before the DXA evaluation to account for a cumulative exposure that could affect bone remodeling. The association with low BMD (Z-score < -2) was assessed by a multiple logistic regression model. The study population was 50 years (median), hepatitis C virus (HCV) (18%), and hepatitis B virus (HBV) (8%) coinfection with HIV-RNA <50 c/mL in 89%, median CD4 of 619/mm ³ . Prevalence of low BMD was 18% in males and 6% in females. The factors associated with a Z-score < -2 in males were uric acid renal loss [adjusted odds ratio (aOR): 6.1; 95% confidence interval (CI): 1.2-31.5; p  = .03], HCV coinfection (aOR: 4.0; 95% CI: 1.3-12.2; p  = .02), and less frequent window of exposure to nevirapine (NVP) (aOR: 0.1; 95% CI: 0.02-0.6; p  = .01). For the full study sample, there was a strong positive association between duration of exposure to NVP and lumbar spine Z-score ( p  = .004). HIV-positive patients exposed to long-term cART have a high incidence of low BMD. Tenofovir disoproxil fumarate and ritonavir-boosted protease inhibitors did not seem to be associated with increased risk of low BMD, whereas NVP exposure appeared to have an independent positive association.

Investigator: G Chêne; R Salamon; JP Moatti; J Pierret; B Spire; F Brun-Vézinet; H Fleury; B Masquelier; G Peytavin; R Garraffo; D Costagliola; P Dellamonica; C Katlama; L Meyer; D Salmon; A Sobel; L Cuzin; M Dupon; V Le Moing; B Marchou; T May; P Morlat; C Rabaud; A Waldner-Combernoux; L Hardel; P Reboud; S Couffin-Cadiergues; L Marchand; A Assuied; P Carrieri; S Habak; F Couturier; C Jadand; A Perrier; M Préau; C Protopopescu; JL Schmit; JM Chennebault; JP Faller; N Magy-Bertrand; C Chirouze; P Humbert; Longy-Boursier; D Neau; P Granier; S Ansart; R Verdon; D Merrien; P Chevojon; A Sobel; Y Levy; L Piroth; C Perronne; E Froguel; J Ceccaldi; C Chidiac; V Grégoire; J Reynes; JG Fuzibet; P Arsac; E Bouvet; F Bricaire; J Monsonego; PM Girard; L Guillevin; S Herson; JM Molina; G Pialoux; O Sain; P Sellier; F Roblot; F Bani-Sadr; C Michelet; F Lucht; C Debord; T Martin; JP De Jaureguiberry; L Bernard
Keywords: HIV; bone mineral density; nevirapine

0 (Reverse Transcriptase Inhibitors)
99DK7FVK1H (Nevirapine)

Date Created: 20200101 Date Completed: 20210405 Latest Revision: 20210405

20221213

10.1089/AID.2019.0229

31891665