Trial reportHIV medicine2015
Prevalence of and risk factors for low bone mineral density in untreated HIV infection: a substudy of the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial.
Trial report in HIV medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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
26 citing papers in PubMed, 47 citations in OpenAlex.
- Trial
- Immediate Initiation of Antiretroviral Therapy for HIV Infection Accelerates Bone Loss Relative to Deferring Therapy: Findings from the START Bone Mineral Density Substudy, a Randomized Trial.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2017Trial
- TDF and quantitative ultrasound bone quality in African patients on second line ART, ANRS 12169 2LADY sub-study.PloS one · 2017Trial
- Challenges, successes and patterns of enrolment in the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial.HIV medicine · 2015Trial
- Relationships Between Physical Activity and Bone Density in People Living with HIV: Results from the SATURN-HIV Study.The Journal of the Association of Nurses in AIDS Care : JANACTrial
- Narrative Review on the Management of Neck of Femur Fractures in People Living with HIV: Challenges, Complications, and Long-Term Outcomes.Microorganisms · 2025Review
- Investigation of Osteoporosis in Persons Living with Human Immunodeficiency Virus: The HOST Study.Calcified tissue international · 2025Article
- Bone Metabolism in Men who Live with HIV Aged 50 years and Over: Impact of Infection Duration.Current HIV research · 2024Article
- The evaluation of risk factors related to reduced bone mineral density in young people living with HIV.African health sciences · 2022Article
- Increased risk factors associated with lower BMD in antiretroviral-therapy-naïve HIV-infected adult male.BMC infectious diseases · 2021Article
- Article
- Negative correlation between bone mineral density and subclinical fractures in patients with human immunodeficiency virus.The Journal of international medical research · 2021Article
- Longitudinal change in bone mineral density among Chinese individuals with HIV after initiation of antiretroviral therapy.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021Article
- Prevalence of osteoporosis and osteopenia in a cohort of HIV positive women with a history of treated neoplasms.SAGE open medicine · 2021Article
- Alcohol and Bone Turnover Markers among People Living with HIV and Substance Use Disorder.Alcoholism, clinical and experimental research · 2020Article
- Older HIV-infected adults: complex patients-comorbidity (I).European geriatric medicine · 2019Article
- Observational
- Alcohol Consumption and Bone Mineral Density in People with HIV and Substance Use Disorder: A Prospective Cohort Study.Alcoholism, clinical and experimental research · 2018Article
- Prevalence of and risk factors for low bone mineral density in Spanish treated HIV-infected patients.PloS one · 2018Article
- Bone Loss in HIV Infection.Current treatment options in infectious diseases · 2017Article
Corrections and comments
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Authors and funding
11 authors at 8 institutions in 6 countries.
Funding
Abstract
objectivesHIV infection is associated with a higher prevalence of low bone mineral density (BMD) and fractures than that found in the general population. There are limited data in HIV-positive adults, naïve to antiretroviral therapy (ART), with which to estimate the relative contribution of untreated HIV infection to bone loss.
methodsThe primary objective of the Strategic Timing of AntiRetroviral Treatment (START) Bone Mineral Density Substudy is to compare the effect of immediate versus deferred initial ART on bone. We evaluated traditional, demographic, HIV-related and immunological factors for their associations with baseline hip and lumbar spine BMD, measured by dual-energy X-ray absorptiometry, using multiple regression.
resultsA total of 424 ART-naïve participants were enrolled at 33 sites on six continents; the mean age was 34 years [standard deviation (SD) 10.1 years], 79.0% were nonwhite, 26.0% were women, and 12.5% had a body mass index (BMI) < 20 kg/m(2) . Mean (SD) Z-scores were -0.41 (0.94) at the spine and -0.36 (0.88) for total hip; 1.9% had osteoporosis and 35.1% had low BMD (hip or spine T-score < -1.0). Factors independently associated with lower BMD at the hip and spine were female sex, Latino/Hispanic ethnicity, lower BMI and higher estimated glomerular filtration rate. Longer time since HIV diagnosis was associated with lower hip BMD. Current or nadir CD4 cell count and HIV viral load were not associated with BMD.
conclusionsIn this geographically and racially diverse population of ART-naïve adults with normal CD4 cell counts, low BMD was common, but osteoporosis was rare. Lower BMD was significantly associated with traditional risk factors but not with CD4 cell count or viral load.
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