Evidence map›Paper›PMID 26659069›Full record

Trial reportOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2016

Associations between vitamin D metabolites, antiretroviral therapy and bone mineral density in people with HIV.

K M Klassen, M G Kimlin, C K Fairley, S Emery, P H Anderson, P R Ebeling, STEAL Study Group

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
3.2field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 14 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Vitamin D and bone loss in HIV.Current opinion in HIV and AIDS · 2016
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

K M KlassenDepartment of Medicine, University of Melbourne, Victoria, 3021, Australia. karenklassen@gmail.com.
M G KimlinAusSun Research Lab, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
C K FairleyCentral Clinical School, Alfred Centre, Monash University, Melbourne, 3004, Australia.
S EmeryThe Kirby Institute, University of New South Wales, Sydney, Australia.
P H AndersonSchool of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia, Australia.
P R EbelingDepartment of Medicine, University of Melbourne, Victoria, 3021, Australia.
STEAL Study Group
The University of Melbourne · AUQueensland University of Technology · AUUniversity of South Australia · AUUNSW Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

rationaleTo see if vitamin D and antiretroviral therapy are associated with bone mineral density (BMD) in people with HIV.

resultLower hip BMD was associated with tenofovir (an antiretroviral medicine) in those with 25(OH)D ≥50 nmol/L. SIGNIFICANCE: The relationship between antiretroviral therapy and hip BMD differs depending on vitamin D status.

introductionPeople with HIV have an increased risk of low BMD and fractures. Antiretroviral therapy contributes to this increased risk. The aim of this study was to evaluate associations between vitamin D metabolites and antiretroviral therapy on BMD.

methodsThe simplification of antiretroviral therapy with tenofovir-emtricitabine or abacavir-lamivudine trial (STEAL) was an open-label, prospective randomised non-inferiority study that compared simplification of current nucleoside reverse transcriptase inhibitors (NRTIs) to fixed-dose combination tenofovir-emtricitabine (TDF-FTC) or abacavir-lamivudine. Serum 25(OH)D and 1,25(OH)2D were measured in 160 individuals (90 receiving TDF-FTC, 70 receiving other NRTIs) at baseline from this study. Multivariable linear regression models were constructed to evaluate the covariates of 1,25(OH)2D and BMD.

resultsProtease inhibitor use (p = 0.02) and higher body mass index (BMI) (p = 0.002) were associated with lower 1,25(OH)2D levels in those with 25(OH)D <50 nmol/L. However, TDF-FTC use (p = 0.01) was associated with higher 1,25(OH)2D levels, but only in those with 25(OH)D ≥50 nmol/L. White ethnicity (p = 0.02) and lower BMI (p < 0.001) in those with 25(OH)D <50 nmol/L and with TDF-FTC use (p = 0.008) in those with 25(OH)D ≥50 nmol/L were associated with lower hip BMD. TDF-FTC use, higher serum calcium and serum βCTX, winter, and lower bone-specific alkaline phosphatase (BALP) and BMI were associated with lower lumbar spine BMD.

conclusionTDF-FTC use (versus non-TDF-FTC use) was associated with lower hip BMD, and this difference was more pronounced in those with 25(OH)D ≥50 nmol/L. Serum 25(OH)D <50 nmol/L was associated with lower hip BMD in all participants. Therefore, the associations between antiretroviral therapy and hip BMD differ depending on vitamin D status.

Indexed as

AbacavirAdultAnti-HIV AgentsBody Mass IndexBone DensityCalcitriolDideoxynucleosidesDrug CombinationsEmtricitabineFemaleHip JointHIV InfectionsHumansLamivudineMaleMiddle Aged25-hydroxyvitamin DAbacavirabacavir, lamivudine drug combinationAnti-HIV AgentsCalcitriolDideoxynucleosidesDrug CombinationsEmtricitabineLamivudineTenofovirVitamin DAntiretroviral therapyBoneHIVVitamin D

Identifiers

PMID26659069
OpenAlexW2192857216

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

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.