Trial reportBMC infectious diseases2012
Prospective evaluation of bone markers, parathormone and 1,25-(OH)₂ vitamin D in HIV-positive patients after the initiation of tenofovir/emtricitabine with atazanavir/ritonavir or efavirenz.
Trial report in BMC infectious diseases, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 41 citations in OpenAlex.
- Longitudinal increase in vitamin D binding protein levels after initiation of tenofovir/lamivudine/efavirenz among individuals with HIV.AIDS (London, England) · 2016Trial
- Trial
- Increased bone resorption during tenofovir plus lopinavir/ritonavir therapy in Chinese individuals with HIV.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2015Trial
- Trial
- Trial
- Beyond DXA: Trabecular Bone Score, Quantitative Ultrasound and Bone Turnover Markers for Morphometric Vertebral Fracture Assessment in People Living with HIV.Diagnostics (Basel, Switzerland) · 2026Article
- Bone Quality in Relation to HIV and Antiretroviral Drugs.Current HIV/AIDS reports · 2022Review
- Multidisciplinary collaborative integrated management of increasingly prominent HIV complications in the post-cART era.HIV medicine · 2020Review
- Elderly HIV-positive women: A gender-based analysis from the Multicenter Italian "GEPPO" Cohort.PloS one · 2019Article
- Continued Interest and Controversy: Vitamin D in HIV.Current HIV/AIDS reports · 2018Review
- Mexican patients with HIV have a high prevalence of vertebral fractures.Infectious disease reports · 2018Article
- Effect of antiretroviral therapy on bone turnover and bone mineral density in men with primary HIV-1 infection.PloS one · 2018Article
- Article
- Osteoporosis in Human Immunodeficiency Virus Patients - An Emerging Clinical Concern.European endocrinology · 2014Review
- Co-administration of ritonavir-boosted protease inhibitors and rate of tenofovir discontinuation in clinical practice.Journal of the International AIDS Society · 2014Article
- Bone turnover and bone mineral density in HIV-1 infected Chinese taking highly active antiretroviral therapy -a prospective observational study.BMC musculoskeletal disorders · 2013Observational
- HIV infection and osteoporosis: pathophysiology, diagnosis, and treatment options.Current osteoporosis reports · 2012Review
- Dairy calcium intake and lifestyle risk factors for bone loss in hiv-infected and uninfected Mediterranean subjects.BMC infectious diseases · 2012Article
- Article
- Bone Deleterious Effects of Different NRTIs in Treatment-naïve HIV Patients After 12 and 48 Weeks of Treatment.Current HIV researchArticle
Corrections and comments
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Authors and funding
17 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIncreased risk of fractures and osteoporosis have been associated with the use of antiretroviral drugs. There is a paucity of prospective evaluations of bone markers after the initiation of drugs currently recommended to treat HIV infection and results on the evolution of these markers are conflicting. Lastly, the effect of tenofovir on 1,25-(OH)₂ vitamin D is uncertain.
methodsWe performed a prospective study on the evolution of bone markers, parathormone and 1,25-(OH)₂ vitamin D before and after standard antiretroviral regimens. This was a sub-study of a trial conducted in antiretroviral-naïve patients randomized to tenofovir + emtricitabine in combination with either atazanavir/ritonavir (ATV/r) or efavirenz (EFV). Follow-up lasted 48 weeks. The following bone markers were analyzed: C-terminal cross-laps (CTx), osteocalcin (OC), osteoprotegerin (OPG), and receptor activator of nuclear factor κB ligand (RANKL). Mixed-factorial analysis of variance with random-coefficient general linear model was used to compare their trends over time and linear multivariable regression was performed with a backward selection method to assess predictors of their variations from baseline to week 48. Trends of parathormone and 1,25-(OH)₂ vitamin D were also evaluated.
resultsSeventy-five patients were studied: 33 received EFV and 42 ATV/r. Significant increases were found for all markers except for RANKL. There was a significant direct association between CTx and OC increases. Multivariable analysis showed that higher glomerular filtration rate (estimated through cystatin C clearance) predicted greater OPG increase, while older age, higher HIV RNA at baseline and use of ATV/r predicted greater CTx increase. A significant increase of parathormone accompanied the evolution of the study markers. 1,25-(OH)₂ vitamin D remained stable, though a seasonality variation was demonstrated.
conclusionsThese data demonstrate CTx increase (bone resorption marker) corresponding to OC increase (bone formation marker) early upon HAART initiation. Moreover, predictors of bone marker increases have been suggested, possibly indicating that a stricter monitoring of bone health and pro-active interventions are needed in older patients, those with higher HIV RNA, prescribed ATV/r rather than EFV, and with decreased renal function at baseline. Further studies are needed to clarify the mechanisms responsible for up-regulation of bone turnover markers, as well as to understand if and what markers are best correlated or predictive of pathological fractures.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.