ArticleAIDS (London, England)2016
Antiretroviral therapy induces a rapid increase in bone resorption that is positively associated with the magnitude of immune reconstitution in HIV infection.
Article in AIDS (London, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 1 of them a synthesis that pooled it.
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Who cites it
63 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Diagnosis, prevention, and treatment of bone fragility in people living with HIV: a position statement from the Swiss Association against Osteoporosis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2019Guideline
- Antiretroviral Therapy-Induced Bone Loss Is Durably Suppressed by a Single Dose of Zoledronic Acid in Treatment-Naive Persons with Human Immunodeficiency Virus Infection: A Phase IIB Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Trial
- Trial
- Decreased bone turnover in HIV-infected children on antiretroviral therapy.Archives of osteoporosis · 2018Trial
- A Single-dose Zoledronic Acid Infusion Prevents Antiretroviral Therapy-induced Bone Loss in Treatment-naive HIV-infected Patients: A Phase IIb Trial.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2016Trial
- Longitudinal increase in vitamin D binding protein levels after initiation of tenofovir/lamivudine/efavirenz among individuals with HIV.AIDS (London, England) · 2016Trial
- Plasma polyunsaturated fatty acid metabolism associations with bone mineral density and bone turnover in pre- and postmenopausal women living with HIV.Clinical nutrition ESPEN · 2026Article
- Development and internal validation of a diagnostic prediction model for osteoporosis in elderly people living with HIV receiving antiretroviral therapy: a cross-sectional study.BMC infectious diseases · 2026Article
- Combined Sequential Antiretroviral Therapy-Induced Immune Reconstitution Bone Loss and Estrogen Deficiency Bone Loss Are Cumulative in Mice Models.The Journal of infectious diseases · 2025Article
- Cumulative incidence and treatment effectiveness of low bone mineral density among people living with HIV in Iran (2021-2023).AIDS research and therapy · 2024Article
- Sex Differences in Metabolic Disorders of Aging and Obesity in People with HIV.Current HIV/AIDS reports · 2024Review
- The anti-HIV drug abacavir stimulates β-catenin activity in osteoblast lineage cells.JBMR plus · 2024Article
- Bone Disease in HIV: Need for Early Diagnosis and Prevention.Life (Basel, Switzerland) · 2024Review
- Cluster-Based Multinomial Logistic Regression Model for Health-Related Quality of Life Among People Living with HIV in Brazil.AIDS and behavior · 2024Article
- Prevalence of and risk factors for vertebral fracture and low bone mineral density among Peruvian women aging with HIV.Archives of osteoporosis · 2023Article
- Bone Health in People Living with HIV/AIDS: An Update of Where We Are and Potential Future Strategies.Microorganisms · 2023Review
- Health-related quality of life and associated factors among people living with HIV/AIDS in Sichuan, China: A cross-sectional study.Frontiers in public health · 2023Article
- Bone Quality in Relation to HIV and Antiretroviral Drugs.Current HIV/AIDS reports · 2022Review
- Immune Reconstitution Bone Loss Exacerbates Bone Degeneration Due to Natural Aging in a Mouse Model.The Journal of infectious diseases · 2022Article
- Osteoporosis and HIV Infection.Calcified tissue international · 2022Review
3 more citing papers are in PubMed but not listed here.
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Authors and funding
11 authors.
Funding
Abstract
objectiveAntiretroviral therapy (ART) paradoxically intensifies bone loss in the setting of HIV infection. Although the extent of bone loss varies, it occurs with virtually all ART types, suggesting a common pathway that may be aligned with HIV disease reversal. Using an animal model of immunodeficiency we recently demonstrated that immune activation associated with CD4 T-cell reconstitution induces increased production of the osteoclastogenic cytokines RANKL and TNFα by immune cells, driving enhanced bone resorption and loss in bone mineral density.
designTo confirm these findings in humans, we investigated the early kinetics of CD4 T-cell recovery in relation to biomarkers of bone turnover and osteoclastogenic regulators in a prospective 24-week cohort study.
methodsClinical data and blood sampling for HIV-RNA PCR, CD4 T-cell counts, bone turnover biomarkers, and osteoclastogenic regulators were obtained from ART-naïve HIV-infected study participants initiating standard doses of lopinavir/ritonavir plus tenofovir disoproxil fumarate/emtricitabine at baseline and at weeks 2, 8, 12, and 24 post ART.
resultsC-terminal telopeptide of collagen (CTx) a sensitive biomarker of bone resorption rose by 200% above baseline at week 12, remaining elevated through week 24 (α<0.01), and was associated with significant increases in plasma levels of osteoclastogenic regulators [receptor activator of NF-kB ligand (RANKL), tumor necrosis factor alpha, (TNFα)]. Importantly, the magnitude of CD4 T-cell recovery correlated significantly with CTx (rs = 0.387, α=0.01).
conclusionOur data suggest that ART-induced bone loss occurs early, is aligned with early events of immune reconstitution, and these immune changes provide a unifying mechanism to explain in part the skeletal decline common to all ART.
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