Skip Navigation LinksHome > April 13, 2001 - Volume 15 - Issue 6 > Osteopenia in HIV-infected men: association with asymptomati...
AIDS:
Basic Science

Osteopenia in HIV-infected men: association with asymptomatic lactic acidemia and lower weight pre-antiretroviral therapy

Carr, Andrewa; Miller, Johnb; Eisman, John A.c; Cooper, David A.a,b

Free Access
Article Outline
Collapse Box

Author Information

From the aHIV, Immunology and Infectious Diseases Clinical Services Unit, St Vincent's Hospital, the bNational Centre in HIV Epidemiology and Clinical Research and the cGarvan Institute for Medical Research, University of New South Wales, Sydney, Australia.

Received: 18 October 2000;

revised: 19 January 2001; accepted: 30 January 2001.

Sponsorship: The National Centre in HIV Epidemiology and Clinical Research is supported by the Commonwealth Department of Health and Aged Care through the Australian National Council on AIDS, Hepatitis C and Related Diseases and its Research Advisory Committee.

Requests for reprints to Associate Professor A. Carr, HIV, Immunology and Infectious Diseases Clinical Services Unit, St Vincent's Hospital, Sydney 2010, Australia; e-mail: acarr@stvincents.com.au

Collapse Box

Abstract

Background: Osteopenia has been associated with antiretroviral therapy, particularly with protease inhibitors. Osteopenia in HIV-uninfected men is associated with mitochondrial defects.

Methods: Bone density was assessed by dual-energy X-ray absorptiometry (DEXA) in 221 HIV-infected men (mean age 43 years) recruited to a lipodystrophy prevalence survey. Additional parameters assessed were demographics, exercise, smoking, type(s) and duration of all antiretroviral therapy, lipodystrophy (overall and by region), CD4 counts, HIV RNA, fasting metabolic parameters (lipid, glycaemic, lactate, liver enzymes, testosterone) and regional body fat and lean mass (DEXA and L4 abdominal computed tomographic scan).

Results: Thirty-two patients were drug-naive; 42 were receiving nucleoside analogue reverse transcriptase inhibitors (NRTI) and 147 were receiving these plus protease inhibitors. Osteoporosis (t-score < −2.5 SD below normal) was found in seven (3%) and osteopenia (t-score −1.0 to −2.5 SD) in 44 (22%). No patient had had a fracture since being infected with HIV. The only factors independently associated on logistic regression with osteopenia or osteoporosis were higher lactate levels, even if asymptomatic [odds ratio (OR) 2.39 per 1 mmol/l increase; 95% confidence interval (CI) 1.39–4.11; P = 0.002), and lower weight prior to commencing antiretroviral therapy (OR 1.06 per 1 kg decrease; 95% CI 1.02–1.11; P = 0.006). There was no independent association with any other parameter, including type or duration of antiretroviral therapy and lipodystrophy at any site. Lower total bone mineral density was associated with lower weight prior to commencing antiretroviral therapy whereas lower spinal bone mineral density was associated mostly with higher lactate.

Conclusion: Osteopenia in HIV-infected men is common, asymptomatic and is associated with asymptomatic NRTI-related lactic acidemia and lower weight pre-antiretroviral therapy.

Back to Top | Article Outline

Introduction

Osteoporosis is a recently described adverse event in patients with HIV infection. Prior to the introduction of long-term highly active antiretroviral therapy, healthy HIV-infected adults generally had normal bone mineral density that was stable over time [1]. This suggests that known risk factors for osteopenia that have always been common in HIV-infected patients, such as smoking, reduced exercise, hypogonadism and cytokine activation, may not play a major role in HIV-related osteopenia.

Two more recent studies found an increased (42% and 38%) prevalence of osteopenia in HIV-infected adult outpatients receiving combination antiretroviral therapy. In one study, osteopenia was linked to protease inhibitor therapy, although potential confounding factors such as nucleoside analogue drug type and duration, smoking, exercise, testosterone, lean body mass and weight prior to therapy were not studied [2]. The second study found a high prevalence in lipodystrophic adults recruited to a randomized study of protease inhibitor cessation [3]. However, no difference in bone density was seen between the two randomized groups after 48 weeks. Although no potential risk factor for osteoporosis was identified, this study population all had lipodystrophy and extensive pretreatment with nucleoside analogues and protease inhibitors. Although both these studies reported no fractures, osteoporotic fractures have been reported in two HIV-infected African women [4].

Osteoporosis has been linked to mitochondrial deletions in young HIV-uninfected males with no other clinical features of mitochondrial disease, although some had asymptomatic lactic acidemia [5,6]. Lactic acidemia is a well-described mitochondrial toxicity of HIV nucleoside analogue therapy [7–13]. To address the possibility that HIV-associated osteopenia might have a mitochondrial pathogenesis, the prevalence of osteopenia or osteoporosis, and of factors associated with their presence, was assessed in a cohort of adult men in whom numerous parameters including lactate and body composition had been studied.

Back to Top | Article Outline

Methods

Subjects

The study population of 221 men comprised 32 antiretroviral-naive patients without lipodystrophy, 14 nucleoside analogue recipients with lipodystrophy, 28 nucleoside analogue recipients without lipodystrophy, 103 nucleoside analogue plus protease inhibitor recipients with lipodystrophy and 44 nucleoside analogue plus protease inhibitor recipients without lipodystrophy [7]. The 14 nucleoside analogue recipients with lipodystrophy were taking part in a study evaluating lipodystrophy and lactic acidemia in patients naive to protease inhibitor therapy and they represented all such outpatients seen between June 1998 and January 1999. The remaining patients were all healthy HIV-infected male outpatients seen for routine care between October, 1998 and February, 1999, who were consecutively recruited to the Australian lipodystrophy prevalence survey (11 of the 14 cases were seen during the latter period and were also recruited to the prevalence survey). No patient had an AIDS-defining condition in the 3 months prior to study.

Age, known duration of HIV infection, presence of AIDS, smoking, current exercise level (graded as sedentary, mild, moderate, high; [14]), types and durations of all antiretroviral therapy, weight (including weight prior to commencing antiretroviral therapy), symptoms and signs associated with lactic acidemia (fatigue, nausea, weight loss of at least 3 kg during the preceding 3 months [ref. 7]), CD4 count, HIV RNA load, electrolytes, liver enzymes, plasma lactate, testosterone and lipid and glycaemic parameters were assessed. For collection of all metabolic parameters, patients undertook no vigorous exercise for 24 h, fasted overnight for 10 h but with free water intake. Lactate measures were not repeated. No assessment of nutritional status, calcium intake, steroid use or exercise type was made. Patient files were reviewed for evidence of prior fracture since diagnosis of HIV infection; prior CD4 lymphocyte counts and plasma HIV RNA results were not recorded.

Body composition was measured within 4 weeks of clinical and metabolic assessments by dual-energy X-ray absorptiometry (DXA; Lunar DPXL, Madison, Wisconsin, USA) in a single scanner. Bone parameters recorded included total body bone mineral density, total body bone mineral density t-score (density compared with healthy male Australians aged 20–45 years) and total body bone mineral density z-score (density compared with Australian age, weight, race and sex-matched adults). Spinal bone mineral density was estimated from the total body scans; for that reason spine t-scores and z-scores could not be determined. Intra-abdominal and extra-abdominal fat at the L4 vertebral level was estimated by single-cut computed tomography.

Osteopenia was defined according to World Health Organization (WHO) criteria by a total body bone mineral density t-score 1.0–2.5 SD below mean normal (an average t-score in young men is zero; an average z-score in a given age, sex and racial group is also zero), and osteoporosis by a total body bone mineral density t-score of > 2.5 SD below mean normal [15]. Lactic acidemia was defined by serum lactate > 2.0 mmol/l and lipodystrophy by patient report (standardized questionnaire) of peripheral lipoatrophy (fat loss from face, arms, buttocks or legs) and/or central fat accumulation (abdomen, dorsocervical fat pad) that was confirmed by physical examination [7].

Because of the small number of patients with osteoporosis, these patients were combined with the osteopenic patients for all analyses. Comparisons between patients with osteopenia or osteoporosis and those with normal bone density used the Mann–Whitney test for continuous variables and Fisher's exact test for categorical variables. Parameters associated with osteopenia or osteoporosis were assessed using logistic regression. All parameters were examined individually, and those parameters significantly (2-sided P ≤ 0.05) associated with osteopenia or osteoporosis were entered into a stepwise regression model. Stepwise logistic regression was also used to evaluate any association of each parameter with lactic acidemia. Parameters associated with total bone mineral density and spinal bone mineral density were assessed using linear regression. All parameters were examined individually, and parameters significantly associated with reduced total bone mineral density or spinal bone mineral density were entered into respective stepwise regression models. As three of the 14 nucleoside analogue recipients with lipodystrophy were studied prior to the lipodystrophy survey, analyses were repeated with exclusion of these three patients; these analyses gave similar results and are not presented.

Back to Top | Article Outline

Results

Subjects

The mean age of the 221 patients was 43 (SD 9) years; the mean duration of HIV infection was 7.6 (4.5) years; 44 (20%) patients had AIDS, 116 (52%) patients had lipodystrophy, 44 (20%) had lactic acidemia and 32 (14%) had symptomatic lactic acidemia (Table 1). The mean CD4 count was 485 × 106 cells/l (SD 284) and plasma viral load was 3.17 log10 copies/ml (SD 0.96). No patient had a documented fracture since being diagnosed with HIV infection.

Table 1
Table 1
Image Tools

The mean (SD) total body bone mineral density in the 221 patients was 1.22 g/cm2 (0.15), equivalent to a t-score of −0.05 (1.17) and a z-score of 0.16 (1.08). Of 51 (23%) patients who had reduced total body bone mineral density, 44 (20%) had osteopenia, and seven (3%) had osteoporosis. Reduced total bone mineral density was found in two (6%) drug-naive patients, 11 (26%) nucleoside analogue recipients and 36 (25%) nucleoside analogue plus protease inhibitor recipients. Australian population data, from which our t-scores are derived, suggest that 16% of age- and race-matched healthy men would be expected to have osteopenia, suggesting the prevalence in the nucleoside analogue plus protease inhibitor recipients was about 50% greater than expected (P = 0.019).

The mean total bone mineral density t-score was 0.58 (1.00) in drug-naive patients, −0.01 (1.22) in nucleoside analogue recipients, and −0.16 (1.16) in nucleoside analogue plus protease inhibitor recipients (P = 0.023). Mean spinal bone mineral density was 1.13 g/cm2 (0.13) in drug-naive patients, 1.06 g/cm2 (0.12) in nucleoside analogue recipients and 1.04 g/cm2(0.11) in nucleoside analogue plus protease inhibitor recipients (P = 0.008).

Patients with osteopenia or osteoporosis had longer durations of HIV infection and of stavudine therapy, higher HIV viral load and lactate (and the known associated parameters of low bicarbonate and raised alkaline phosphatase), more symptomatic lactic acidemia, more lipoatrophy (but not more central fat accumulation), lower body weight pre-antiretroviral therapy and lower current weight, lean body mass, total fat mass and peripheral fat mass (Table 1).

The only parameters independently associated with osteopenia or osteoporosis were higher lactate [odds ratio (OR) 2.39 per 1 mmol/l increase; 95% confidence interval (CI) 1.39–4.11; P = 0.002] and lower weight prior to commencing antiretroviral therapy (OR 1.06 per 1 kg decrease; 95% CI 1.02–1.11]; P = 0.006; Table 2). Osteopenia was associated with both symptomatic and asymptomatic lactic acidemia and was significantly associated with lactate at any level > 2.0 mmol/l. In turn, factors independently associated with lactic acidemia were current didanosine therapy (OR 6.10; 95% CI 2.67–13.89; P < 0.0001) and current stavudine therapy (OR 2.90; 95% CI 1.25–6.71; P = 0.013). There was no association with current smoking; current exercise level; the use, duration or type of protease inhibitor or non-nucleoside analogue therapy; central fat accumulation (abdomen or dorsocervical spine); total or high density lipoprotein cholesterol; triglycerides; glucose; insulin; C-peptide; or estimated insulin resistance (data not shown).

Table 2
Table 2
Image Tools

The only parameters independently associated with lower total bone mineral density were greater age, lower lean body mass and greater duration of stavudine therapy (Table 3). In contrast, for lower spinal bone mineral density, the only independently associated parameters on linear regression were greater age, higher lactate levels and greater total duration of all nucleoside analogue therapy.

Table 3
Table 3
Image Tools
Back to Top | Article Outline

Discussion

The present study has confirmed previous studies that found osteopenia to be common in HIV-infected adult males receiving antiretroviral therapy even after adjustment for age. This osteopenia may result from mitochondrial toxicity of nucleoside analogues because osteopenia was associated with lactic acidemia (and lactic acidemia in turn with nucleoside analogue therapy), and the significant association on univariate logistic regression with nucleoside analogue therapy (a major cause of lactic acidemia) was lost after adjustment for lactate level (Table 2).

Overall, the data suggest that the cumulative duration and magnitude of lactic acidemia induced by nucleoside reverse transcriptase inhibitors may be most responsible for the increase in loss of bone mineral mass in our patients. Osteopenia was not directly associated, however, with any particular nucleoside analogue (although only 13 patients were receiving abacavir and so no conclusion about its impact can be made). This suggests that osteopenia can develop with any nucleoside analogue but mostly if lactic acidemia is present. Didanosine was most linked to lactic acidemia but was not significantly associated with osteopenia. Given the observed nucleoside analogue duration effect, it may be the relatively shorter period of didanosine therapy was sufficient to raise lactate but not to lower bone mineral density.

There are at least two possible explanations as to why lactic acidemia could be associated with osteopenia. As noted, mitochondrial deletions have been associated with osteoporosis and lactic acidemia in young adult males with no other overt signs of mitochondrial disease [5,6]. It remains to be determined, however, whether the observed increase in lactate derives from bone or is merely a parallel phenomenon. A second possibility to explain the link between lactic acidemia and osteopenia is that increased lactate production elsewhere (such as the liver) is being buffered by calcium hydroxyapatite from bone for subsequent urinary excretion, as has been observed in studies of increased protein intake, which also incurs a significant acid load. The predominant association of lactic acidemia with reduced spinal bone density might be explained by the fact that cancellous/trabecular bone, which forms the greater proportion of vertebral bone, is a more labile store of calcium than is cortical long bone, and so the spine might be more susceptible to the effects of lactic acidemia and/or nucleoside analogues.

There was no independent association between osteopenia and protease inhibitor duration, use or type. Similarly, neither hyperlipidemia nor insulin resistance, both common complications of protease inhibitor therapy, was linked with osteopenia or reduced spinal bone density [16,17]. This may explain why protease inhibitor withdrawal in a randomized study found no beneficial impact on bone density over 48 weeks [3]. Nevertheless, the association of reduced spinal bone mineral density with protease inhibitor duration deserves further investigation. Assessment of osteopenia in studies of nucleoside analogue withdrawal will also be important.

As osteoporosis to date is relatively rare and almost exclusively asymptomatic, there appears little need to screen routinely for osteoporosis or to alter nucleoside analogue therapy based on bone density data until it is established prospectively whether nucleoside analogues cause osteopenia and whether their cessation can lead to improved bone density. However, it may be prudent to address modifiable risk factors in patients found to have osteopenia, such as smoking, alcohol abuse, physical inactivity and hypogonadism. It will also be important to determine the prevalence of and risk factors for osteoporotic fractures in larger studies.

There are inherent weaknesses of the present study. First, the study was not prospective nor randomized, and so the possibility remains that unmeasured biases might underlie the associations observed. This seems unlikely, however, as not only was lactic acidemia significantly associated with osteopenia, but so also were low bicarbonate and raised alkaline phosphatase, both features of lactic acidemia [7,10–15]. Second, the study has not evaluated women (in whom osteopenia is likely to be more common), children or various racial groups. Third, HIV-negative adult men were not studied. Australian population data (from which the t-scores and z-scores are derived) suggest, however, that about 16% of age- and race-matched healthy men would be expected to have osteopenia. This would indicate a prevalence in HIV-infected men of approximately 50% higher than expected. Lastly, whole body DEXA, rather than specific bone DEXA, was used for estimation of bone parameters, although a high correlation between both methods for estimation of bone mass and density has been observed [2]. Prospective studies will be required to define the relative contributions of antiretroviral therapy and HIV infection to osteopenia.

Lactate is not routinely measured in nucleoside analogue recipients, and nucleoside analogue therapy is generally ceased only in patients with symptomatic lactic acidemia greater than 5 mmol/l. As asymptomatic (low-level) lactic acidemia occurs in 12–20% of nucleoside analogue recipients [7,13] and is now linked to osteopenia, measurement of lactate in nucleoside analogues recipients without symptoms of lactic acidemia who have a fracture, osteoporosis or other risk factors for osteoporosis should be considered.

Back to Top | Article Outline

Acknowledgements

We would like to thank Matthew Law and Katherine Samaras for advice regarding the statistical analyses, Christine Morton for assistance with data collection, Lesley Campbell for review of the manuscript, and the patients for their participation.

Back to Top | Article Outline

References

1. Paton NJ, Macallan DC, Griffin GE, Pazianas M. Bone mineral density in patients with human immunodeficiency virus infection. Calcif Tissue Int 1997, 61: 30 –32.

2. Tebas P, Powderly WG, Claxton S. et al. Accelerated bone mineral loss in HIV-infected patients receiving potent antiretroviral therapy. AIDS 2000, 14: F63 –F67.

3. Hoy J, Hudson J, Law M, Cooper DA. Osteopenia in a randomised, multicentre study of protease inhibitor substitution in patients with lipodystrophy syndrome and well-controlled HIV viraemia: extended follow-up to 48 weeks. Second International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV. Toronto, September 2000 [abstract P32].

4. Stephens EA, Das R, Madge S, Barter J, Johnson MA. Symptomatic osteoporosis in two young HIV-positive African women. AIDS 1999, 13: 2605 –2606.

5. Varanasi SS, Francis RM, Berger CE, Papiha SS, Datta HK. Mitochondrial DNA deletion associated oxidative stress and severe male osteoporosis. Osteoporos Int 1999, 10: 143 –149.

6. Papiha SS, Rathod H, Briceno I, Pooley J, Datta HK. Age-related somatic mitochondrial DNA deletions in bone. J Clin Pathol 1998, 51: 117 –120.

7. Carr A, Miller J, Law M, Cooper DA. A syndrome of lipoatrophy, lactic acidaemia and liver dysfunction associated with HIV nucleoside analogue therapy: contribution to protease inhibitor-related lipodystrophy syndrome. AIDS 2000, 14: F25 –F32.

8. Freiman JP, Helfert KE, Hamrell MR, Stein DS. Hepatomegaly with severe steatosis in HIV-seropositive patients. AIDS 1993, 7: 379 –385.

9. Chatta G, Arieff AI, Cummings C, Tierney IM. Lactic acidosis complicating the acquired immunodeficiency syndrome. Ann Intern Med 1993, 118: 37 –39.

10. Bissuel F, Brunell F, Habersetzer F. et al. Fulminant hepatitis with severe lactate acidosis in HIV-1-infected patients on didanosine therapy. J Intern Med 1994, 235: 367 –372.

11. Fontage IS, Belitos PC, Chaisson RE, Moore RD. Hepatomegaly and steatosis in HIV-infected patients receiving nucleoside analogue antiretroviral therapy. Am J Gastroenterol 1995, 90: 1433 –1436.

12. Lenzo NP, Garas BA, French MA. Hepatic steatosis and lactic acidosis associated with stavudine treatment in an HIV patient: a case report. AIDS 1997, 11: 1294 –1296.

13. Boubaker K, Sudre P, Flepp M et al. Hyperlactatemia and antiretroviral therapy in the Swiss HIV Cohort Study. Seventh Conference on Retroviruses and Opportunistic Infections. San Francisco, January 2000 [abstract 57].

14. Jeppeson J, Hein HO, Suadicani P, Gyntelberg F. Triglyceride concentration and ischemic heart disease: an eight year follow-up in the Copenhagen male study. Circulation 1998, 97: 1029 –1036.

15. Kanis JA, Delmas P, Burckhardt P, Cooper C, Torgerson D. Guidelines for diagnosis and management of osteoporosis. The European Foundation for Osteoporosis and Bone Disease. Osteoporos Int 1994, 4: 325 –331.

16. Carr A, Samaras K, Thorisdottir A, Kaufmann G, Chisholm DJ, Cooper DA. Diagnosis, prediction and natural course of HIV protease inhibitor-associated lipodystrophy, hyperlipidaemia and diabetes mellitus. Lancet 1999, 353: 2893 –2899.

17. Danner SA, Carr A, Leonard J. et al. Safety, pharmacokinetics and preliminary efficacy of ritonavir, an inhibitor of HIV-1 protease. N Engl J Med 1995, 333: 1528 –1533.

Cited By:

This article has been cited 113 time(s).

Journal of Korean Medical Science
Prevalence and Risk Factors of Low Bone Mineral Density in Korean HIV-Infected Patients: Impact of Abacavir and Zidovudine
Kim, HS; Chin, BS; Shin, HS
Journal of Korean Medical Science, 28(6): 827-832.
10.3346/jkms.2013.28.6.827
CrossRef
Hiv Clinical Trials
Alendronate reduces bone resorption in HIV-associated osteopenia/osteoporosis
Guaraldi, G; Orlando, G; Madeddu, G; Vescini, F; Ventura, P; Campostrini, S; Mura, MS; Parise, N; Caudarella, R; Esposito, R
Hiv Clinical Trials, 5(5): 269-277.

Clinical Infectious Diseases
CD4(+) cell count, viral load, and highly active antiretroviral therapy use are independent predictors of body composition alterations in HIV-infected adults: A longitudinal study
McDermott, AY; Terrin, N; Wanke, C; Skinner, S; Tchetgen, E; Shevitz, AH
Clinical Infectious Diseases, 41(): 1662-1670.

Current Molecular Medicine
Bone diseases associated with human immunodeficiency virus infection: Pathogenesis, risk factors and clinical management
Bongiovanni, M; Tincati, C
Current Molecular Medicine, 6(4): 395-400.

Current Hiv Research
Progenitor Cell Types in HIV-1 Infection: Bioactivity and Emerging Targets for Treatment
Cotter, EJ; Doran, PP; Powderly, WG
Current Hiv Research, 7(5): 508-518.

Clinical Infectious Diseases
Lactic acidemia in infection with human immunodeficiency virus
Carr, A
Clinical Infectious Diseases, 36(): S96-S100.

Clinical Infectious Diseases
Emerging bone problems in patients infected with human immunodeficiency virus
Mondy, K; Tebas, P
Clinical Infectious Diseases, 36(): S101-S105.

AIDS
Alterations in bone mineral metabolism in Brazilian HIV-infected patients
Santos, ACS; Crisostomo, LML; Olavarria, V; Brites, C; Galvao-Castro, B
AIDS, 17(): 1578-+.
10.1097/01.aids.0000072674.21517.18
CrossRef
Journal of Clinical Endocrinology & Metabolism
Reduced bone mineral density in human immunodeficiency virus-infected patients and its association with increased central adiposity and postload hyperglycemia
Brown, TT; Ruppe, MD; Kassner, R; Kumar, P; Kehoe, T; Dobs, AS; Timpone, J
Journal of Clinical Endocrinology & Metabolism, 89(3): 1200-1206.
10.1210/jc.2003-031506
CrossRef
Clinical Endocrinology
Bone mineral density remains stable in HAART-treated HIV-infected men over 2 years
Bolland, MJ; Grey, AB; Horne, AM; Briggs, SE; Thomas, MG; Ellis-Pegler, RB; Woodhouse, AF; Gamble, GD; Reid, IR
Clinical Endocrinology, 67(2): 270-275.
10.1111/j.1365-2265.2007.02875.x
CrossRef
Journal of Midwifery & Womens Health
Hormonal contraception and HIV-positive women: Metabolic concerns and management strategies
Womack, J; Richman, S; Tien, PC; Grey, M; Williams, A
Journal of Midwifery & Womens Health, 53(4): 362-375.
10.1016/j.jmwh.2008.01.006
CrossRef
Journal of Acquired Immune Deficiency Syndromes
Bone mineral content is lower in prepubertal HIV-infected children
Arpadi, SM; Horlick, M; Thornton, J; Cuff, PA; Wang, J; Kotler, DP
Journal of Acquired Immune Deficiency Syndromes, 29(5): 450-454.

Journal of Biological Chemistry
Select HIV protease inhibitors alter bone and fat metabolism ex vivo
Jain, RG; Lenhard, JM
Journal of Biological Chemistry, 277(): 19247-19250.
10.1074/jbc.C200069200
CrossRef
International Journal of Std & AIDS
A case of march fracture in a patient with osteoporosis on long-term HAART
Forsyth, SF; Gazzard, BG; Nelson, MR
International Journal of Std & AIDS, 13(9): 645-646.

Journal of Bone and Mineral Research
BMD is reduced in HIV-infected men irrespective of treatment
Amiel, C; Ostertag, A; Slama, L; Baudoin, C; N'Guyen, T; Lajeunie, E; Neit-Ngeilh, L; Rozenbaum, W; De Vernejoul, MC
Journal of Bone and Mineral Research, 19(3): 402-409.
10.1359/JBMR.0301246
CrossRef
Antimicrobial Agents and Chemotherapy
Biological effects of short-term or prolonged administration of 9-[2-(phosphonomethoxy)propyl]adenine (tenofovir) to newborn and infant rhesus macaques
Van Rompay, KKA; Brignolo, LL; Meyer, DJ; Jerome, C; Tarara, R; Spinner, A; Hamilton, M; Hirst, LL; Bennett, DR; Canfield, DR; Dearman, TG; Von Morgenland, W; Allen, PC; Valverde, C; Castillo, AB; Martin, RB; Samii, VF; Bendele, R; Desjardins, J; Marthas, ML; Pedersen, NC; Bischofberger, N
Antimicrobial Agents and Chemotherapy, 48(5): 1469-1487.
10.1128/AAC.48.5.1469.1487.2004
CrossRef
American Journal of Health-System Pharmacy
Identification, management, and prevention of adverse effects associated with highly active antiretroviral therapy
Schiller, DS
American Journal of Health-System Pharmacy, 61(): 2507-2522.

Clinical Nutrition
Hyperlactataemia and lactic acidosis in HIV-infected patients receiving antiretroviral therapy
Calza, L; Manfredi, R; Chiodo, F
Clinical Nutrition, 24(1): 5-15.
10.1016/j.clnu.2004.03.009
CrossRef
Journal of Infectious Diseases
Low Bone Mineral Density, Renal Dysfunction, and Fracture Risk in HIV Infection: A Cross-Sectional Study
Calmy, A; Fux, CA; Norris, R; Vallier, N; Delhumeau, C; Samaras, K; Hesse, K; Hirschel, B; Cooper, DA; Carr, A
Journal of Infectious Diseases, 200(): 1746-1754.
10.1086/644785
CrossRef
Canadian Medical Association Journal
Symptomatic hyperlactatemia in an HIV-positive patient: a case report and discussion
Antoniou, T; Weisdorf, T; Gough, K
Canadian Medical Association Journal, 168(2): 195-198.

Clinical Infectious Diseases
Bone disorders in human immunodeficiency virus infection
Glesby, MJ
Clinical Infectious Diseases, 37(): S91-S95.

Hiv Clinical Trials
Relationship between low bone mineral density and highly active antiretroviral therapy including protease inhibitors in HIV-infected patients
Fernandez-Rivera, J; Garcia, R; Lozano, F; Macias, J; Garcia-Garcia, JA; Mira, JA; Corzo, JE; Gomez-Mateos, J; Rueda, A; Sanchez-Burson, J; Pineda, JA
Hiv Clinical Trials, 4(5): 337-346.

Biomedicine & Pharmacotherapy
Osteopenia and osteoporosis in HIV plus patients, untreated or receiving HAART
Landonio, S; Quirino, T; Bonfanti, P; Gabris, A; Boccassini, L; Gulisano, C; Vulpio, L; Ricci, E; Carrabba, M; Vigevani, GM
Biomedicine & Pharmacotherapy, 58(9): 505-508.
10.1016/j.biopha.2004.08.019
CrossRef
Clinical Chemistry and Laboratory Medicine
The effect of long-term storage on measured plasma lactate concentrations and prospective lactate results from a multicenter trial of antiretroviral therapy
Dube, MP; Kitch, DW; Parker, RA; Alston-Smith, BL; Mulligan, K
Clinical Chemistry and Laboratory Medicine, 43(9): 947-952.
10.1515/CCLM.2005.162
CrossRef
Clinical Infectious Diseases
Bone disease and HIV infection
Amorosa, V; Tebas, P
Clinical Infectious Diseases, 42(1): 108-114.

Journal of Orthopaedic Research
Tenofovir treatment at 30 mg/kg/day can inhibit cortical bone mineralization in growing rhesus monkeys (Macaca mulatta)
Castillo, AB; Tarantal, AF; Watnik, MR; Martin, RB
Journal of Orthopaedic Research, 20(6): 1185-1189.
PII S0736-0266(02)00074-8
CrossRef
Mitochondrion
Mitochondrial injury in the pathogenesis of antiretroviral-induced hepatic steatosis and lactic acidemia
Day, L; Shikuma, C; Gerschenson, M
Mitochondrion, 4(): 95-109.
10.1016/j.mito.2004.06.011
CrossRef
Clinical Infectious Diseases
Effect of reducing the dose of stavudine on body composition, bone density, and markers of mitochondrial toxicity in HIV-infected subjects: A randomized, controlled study
McComsey, GA; Lo Re, V; O'Riordan, M; Walker, UA; Lebrecht, D; Baron, E; Mounzer, K; Frank, I
Clinical Infectious Diseases, 46(8): 1290-1296.
10.1086/529384
CrossRef
British Medical Bulletin
Bone health in HIV infection
Pollock, E; Klotsas, AE; Compston, J; Gkrania-Klotsas, E
British Medical Bulletin, 92(1): 123-133.
10.1093/bmb/ldp037
CrossRef
Journal of Clinical Endocrinology & Metabolism
Low Bone Mass and High Bone Turnover in Postmenopausal Human Immunodeficiency Virus-Infected Women
Yin, MT; McMahon, DJ; Ferris, DC; Zhang, CA; Shu, AM; Staron, R; Colon, I; Laurence, J; Dobkin, JF; Hammer, SM; Shane, E
Journal of Clinical Endocrinology & Metabolism, 95(2): 620-629.
10.1210/jc.2009-0708
CrossRef
Clinical Endocrinology
Bone mineral density is not reduced in HIV-infected Caucasian men treated with highly active antiretroviral therapy
Bolland, MJ; Grey, AB; Horne, AM; Briggs, SE; Thomas, MG; Ellis-Pegler, RB; Woodhouse, AF; Gamble, GD; Reid, IR
Clinical Endocrinology, 65(2): 191-197.
10.1111/j.1365-2265.2006.02572.x
CrossRef
Hiv Clinical Trials
Effects of HIV infection on body composition changes among men of different racial/ethnic origins
Visnegarwala, F; Shlay, JC; Barry, V; Gibert, CL; Xiang, Y; Wang, J; Kotler, D; Raghavan, S; Ei-Sadr, WM; Beirn, T
Hiv Clinical Trials, 8(3): 145-154.
10.1310/hct.0803-145
CrossRef
Antiviral Therapy
The association of bone mineral density with HIV infection and antiretroviral treatment in women
Anostos, K; Lu, D; Shi, Q; Mulligan, K; Tien, PC; Freeman, R; Cohen, MH; Justman, J; Hessol, NA
Antiviral Therapy, 12(7): 1049-1058.

New Microbiologica
Bone alterations during HIV infection
De Crignis, E; Cimatti, L; Borderi, M; Gibellini, D; Re, MC
New Microbiologica, 31(2): 155-164.

AIDS
Antiretroviral therapy and the prevalence of osteopenia and osteoporosis: a meta-analytic review
Brown, TT; Qaqish, RB
AIDS, 20(): 2165-2174.

Joint Bone Spine
Bone loss in patients with HIV infection
Paccou, J; Viget, N; Legrout-Gerot, I; Yazdanpanah, Y; Cortet, B
Joint Bone Spine, 76(6): 637-641.
10.1016/j.jbspin.2009.10.003
CrossRef
Joint Bone Spine
Osteopenia and human immunodeficiency virus
Delaunay, C; Loiseau-Peres, S; Benhamou, CL
Joint Bone Spine, 69(2): 105-108.
UNSP S1297319X02003573/EDI
CrossRef
Microbiologica
HIV-1, HAART and bone metabolism
Borderi, M; Farneti, B; Tampellini, L; Giuliani, R; Verucchi, G; Vescini, F; Caudarella, R; Chiodo, F
Microbiologica, 25(3): 375-384.

Journal of Clinical Endocrinology & Metabolism
Longitudinal changes of bone mineral density and metabolism in antiretroviral-treated human immunodeficiency virus-infected children
Mora, S; Zamproni, I; Beccio, S; Bianchi, R; Giacomet, V; Vigano, A
Journal of Clinical Endocrinology & Metabolism, 89(1): 24-28.
10.1210/jc.2003-030767
CrossRef
Clinical Infectious Diseases
Primary care guidelines for the management of persons infected with human immunodeficiency virus: Recommendations of the HIV Medicine Association of the Infectious Diseases Society of America
Aberg, JA; Gallant, JE; Anderson, J; Oleske, JM; Libman, H; Currier, JS; Stone, VE; Kaplan, JE
Clinical Infectious Diseases, 39(5): 609-629.

Journal of Clinical Densitometry
Total body composition by DXA of 241 HIV-negative men and 162 HIV-infected men - Proposal of reference values for defining lipodystrophy
Bonnet, E; Delpierre, C; Sommet, A; Marion-Latard, F; Herve, R; Aquilina, C; Labau, E; Obadia, M; Marchou, B; Massip, R; Perret, B; Bernard, J
Journal of Clinical Densitometry, 8(3): 287-292.
10.1220/1094-6950
CrossRef
Journal of Clinical Endocrinology & Metabolism
Low body weight mediates the relationship between HIV infection and low bone mineral density: A meta-analysis
Bolland, MJ; Grey, AB; Gamble, GD; Reid, IR
Journal of Clinical Endocrinology & Metabolism, 92(): 4522-4528.
10.1210/jc.2007-1660
CrossRef
Jaids-Journal of Acquired Immune Deficiency Syndromes
Metabolic abnormalities in HIV disease and injection drug use
Dobs, A; Brown, T
Jaids-Journal of Acquired Immune Deficiency Syndromes, 31(): S70-S77.
10.1097/01.QAI.0000028067.79472.C2
CrossRef
AIDS
Decreased bone mineral density in HIV-infected patients is independent of antiretroviral therapy
Bruera, D; Luna, N; David, DO; Bergoglio, LA; Zamudio, J
AIDS, 17(): 1917-1923.
10.1097/01.aids.0000076322.42412.6f
CrossRef
Osteoporosis International
Risk factors for decreased bone density and effects of HIV on bone in the elderly
Jones, S; Restrepo, D; Kasowitz, A; Korenstein, D; Wallenstein, S; Schneider, A; Keller, MJ
Osteoporosis International, 19(7): 913-918.
10.1007/s00198-007-0524-8
CrossRef
AIDS Research and Human Retroviruses
Ethnic variations in the prevalence of metabolic bone disease among HIV-positive patients with lipodystrophy
Curtis, JR; Smith, B; Weaver, M; Landers, K; Lopez-Ben, R; Raper, JL; Saag, M; Venkataraman, R; Saag, KG
AIDS Research and Human Retroviruses, 22(2): 125-131.

Antiviral Therapy
Polyphenotypic expression of mitochondrial toxicity caused by nucleoside reverse transcriptase inhibitors
Miller, RF; Shahmanesh, M; Hanna, MG; Unwin, RJ; Schapira, AHV; Weller, IVD
Antiviral Therapy, 8(3): 253-257.

Skeletal Development and Remodeling in Health, Disease, and Aging
Pathogenesis of osteopenia/osteoporosis induced by highly active anti-retroviral therapy for AIDS
Pan, G; Yang, Z; Ballinger, SW; Mcdonald, JM
Skeletal Development and Remodeling in Health, Disease, and Aging, 1068(): 297-308.
10.1196/annals.1346.057
CrossRef
European Journal of Medical Research
Growth hormone and bone mineral densitiy in HIV-1-infected male subjects
Teichmann, J; Lange, U; Discher, T; Lohmeyer, J; Stracke, H; Bretzel, RG
European Journal of Medical Research, 13(4): 173-178.

Journal of Clinical Endocrinology & Metabolism
Fracture prevalence among human immunodeficiency virus (HIV)-infected versus non-HIV-infected patients in a large US healthcare system
Triant, VA; Brown, TT; Lee, H; Grinspoon, SK
Journal of Clinical Endocrinology & Metabolism, 93(9): 3499-3504.
10.1210/jc.2008-0828
CrossRef
European Journal of Medical Research
Bone Mineral Density in Human Immunodeficiency Virus-1 Infected Men With Hypogonadism Prior to Highly-Active-Antiretroviral-Therapy (Haart)
Teichmann, J; Lange, U; Discher, T; Lohmeyer, J; Stracke, H; Bretzel, RG
European Journal of Medical Research, 14(2): 59-64.

Medicina Clinica
Bone metabolism disorders and avascular bone necrosis: a further problem in HIV-infected patients?
Rodero, FG; Urrea, SP
Medicina Clinica, 119(3): 103-108.

Current Drug Metabolism
Combinations against combinations: Associations of anti-HIV 1 reverse transcriptase drugs challenged by constellations of drug resistance mutations
Maga, G; Spadari, S
Current Drug Metabolism, 3(1): 73-95.

Hiv Medicine
Osteoprotegerin and bone turnover markers in heavily pretreated HIV-infected patients
Seminari, E; Castagna, A; Soldarini, A; Galli, L; Fusetti, G; Dorigatti, F; Hasson, H; Danise, A; Guffanti, M; Lazzarin, A; Rubinacci, A
Hiv Medicine, 6(3): 145-150.

Journal of Clinical Endocrinology & Metabolism
Longitudinal analysis of bone density in human immunodeficiency virus-infected women
Dolan, SE; Kanter, JR; Grinspoon, S
Journal of Clinical Endocrinology & Metabolism, 91(8): 2938-2945.
10.1210/jc.2006-0127
CrossRef
Enfermedades Infecciosas Y Microbiologia Clinica
Bone mineral loss in patients with human immunodeficiency virus infection
Ohnos, JM; Gonzalez-Macias, J
Enfermedades Infecciosas Y Microbiologia Clinica, 26(4): 212-219.

Pediatrics
Osteonecrosis of the hip (Legg-Calve-Perthes disease) in human immunodeficiency virus-infected children
Gaughan, DM; Mofenson, LM; Hughes, MD; Seage, GR; Ciupak, GL; Oleske, JM
Pediatrics, 109(5): -.
ARTN e74
CrossRef
Pharmacotherapy
Bone disorders associated with the human immunodeficiency virus: Pathogenesis and management
Qaqish, RB; Sims, KA
Pharmacotherapy, 24(): 1331-1346.

Hiv Clinical Trials
First-line therapy and mitochondrial damage: Different nucleosides, different findings
Blanco, F; Garcia-Benayas, T; de la Cruz, JJ; Gonzalez-Lahoz, J; Soriano, V
Hiv Clinical Trials, 4(1): 11-19.

Presse Medicale
Osteopathies that weaken HIV-infected patients
David, R
Presse Medicale, 32(): 1857-1863.

Clinical Endocrinology
Thyroid function in human immunodeficiency virus patients treated with highly active antiretroviral therapy (HAART): a longitudinal study
Madeddu, G; Spanu, A; Chessa, F; Calia, GM; Lovigu, C; Solinas, P; Mannazzu, M; Falchi, A; Mura, MS; Madeddu, G
Clinical Endocrinology, 64(4): 375-383.
10.1111/j.1365-2265.2006.02472.x
CrossRef
Journal of Antimicrobial Chemotherapy
Non-nucleoside-reverse-transcriptase-inhibitor-based HAART and osteoporosis in HIV-infected subjects
Bongiovanni, M; Fausto, A; Cicconi, P; Aliprandi, A; Cornalba, G; Bini, T; Sardanelli, F; Monforte, AD
Journal of Antimicrobial Chemotherapy, 58(2): 485-486.
10.1093/jac/dkl229
CrossRef
Journal of Gerontological Nursing
Successful Aging with HIV A Brief Overview for Nursing
Vance, DE; Childs, G; Moneyham, L; McKie-Bell, P
Journal of Gerontological Nursing, 35(9): 19-25.
10.3928/00989134-20090731-04
CrossRef
Annals of Hematology
Increased bone resorption is implicated in the pathogenesis of bone loss in hemophiliacs: correlations with hemophilic arthropathy and HIV infection
Katsarou, O; Terpos, E; Chatzismalis, P; Provelengios, S; Adraktas, T; Hadjidakis, D; Kouramba, A; Karafoulidou, A
Annals of Hematology, 89(1): 67-74.
10.1007/s00277-009-0759-x
CrossRef
Clinical Infectious Diseases
HIV infection and bone mineral density in middle-aged women
Arnsten, JH; Freeman, R; Howard, AA; Floris-Moore, M; Santoro, N; Schoenbaum, EE
Clinical Infectious Diseases, 42(7): 1014-1020.

AIDS Research and Human Retroviruses
High Frequency of Vitamin D Deficiency in Ambulatory HIV-Positive Patients
Rodriguez, M; Daniels, B; Gunawardene, S; Robbins, GK
AIDS Research and Human Retroviruses, 25(1): 9-14.
10.1089/aid.2008.0183
CrossRef
Journal of Acquired Immune Deficiency Syndromes
Long-term exposure to lifelong therapies
Powderly, WG
Journal of Acquired Immune Deficiency Syndromes, 29(): S28-S40.

Clinical Pharmacokinetics
Interactions between antiretroviral drugs and drugs used for the therapy of the metabolic complications encountered during HIV infection
Fichtenbaum, CJ; Gerber, JG
Clinical Pharmacokinetics, 41(): 1195-1211.

AIDS Research and Human Retroviruses
Relationship between osteopenia, free testosterone, and vitamin D metabolite levels in HIV-infected patients with and without highly active antiretroviral therapy
Ramayo, E; Gonzalez-Moreno, MP; Macias, J; Cruz-Ruiz, M; Mira, JA; Villar-Rueda, AM; Garcia-Garcia, JA; Gomez-Mateos, JM; Lozano, F; Pineda, JA
AIDS Research and Human Retroviruses, 21(): 915-921.

Infection
The possible association between serum cholesterol concentration and decreased bone mineral density as well as intravertebral marrow fat in HIV-1 infected patients
Wiercinska-Drapalo, A; Jaroszewicz, J; Tarasow, E; Siergiejczyk, L; Prokopowicz, D
Infection, 35(1): 46-48.
10.1007/s15010-007-5033-3
CrossRef
Antiviral Research
HIV1 protease inhibitors selectively induce inflammatory chemokine expression in primary human osteoblasts
Malizia, AP; Vioreanu, MH; Doran, PP; Powderly, WG
Antiviral Research, 74(1): 72-76.
10.1016/j.antiviral.2006.12.003
CrossRef
Metabolic Syndrome and Related Disorders
Human Immunodeficiency Virus and Highly Active Antiretroviral Therapy-Associated Metabolic Disorders and Risk Factors for Cardiovascular Disease
Anuurad, E; Semrad, A; Berglund, L
Metabolic Syndrome and Related Disorders, 7(5): 401-409.
10.1089/met.2008.0096
CrossRef
Clinical Infectious Diseases
Longitudinal evolution of bone mineral density and bone markers in human immunodeficiency virus-infected individuals
Mondy, K; Yarasheski, K; Powderly, WG; Whyte, M; Claxton, S; DeMarco, D; Hoffmann, M; Tebas, P
Clinical Infectious Diseases, 36(4): 482-490.

Journal of Clinical Endocrinology & Metabolism
Metabolic bone disease in human immunodeficiency virus-infected children
Arpadi, S; Horlick, M; Shane, E
Journal of Clinical Endocrinology & Metabolism, 89(1): 21-23.
10.1210/jc.2003-031942
CrossRef
Bone
Enhanced mitochondrial biogenesis contributes to Wnt induced osteoblastic differentiation of C3H10T1/2 cells
An, JH; Yang, JY; Ahn, BY; Cho, SW; Jung, JY; Cho, HY; Cho, YM; Kim, SW; Park, KS; Kim, SY; Lee, HK; Shin, CS
Bone, 47(1): 140-150.
10.1016/j.bone.2010.04.593
CrossRef
Current Drug Targets
Emerging drug toxicities of highly active antiretroviral therapy for human immunodeficiency virus (HIV) infection
Heath, KV; Montaner, JSG; Bondy, G; Singer, J; O'Shaughnessy, MV; Hogg, RS
Current Drug Targets, 4(1): 13-22.

AIDS Research and Human Retroviruses
AZT enhances osteoclastogenesis and bone loss
Pan, G; Wu, XJ; McKenna, MA; Feng, X; Nagy, TR; McDonald, JM
AIDS Research and Human Retroviruses, 20(6): 608-620.

Hiv Clinical Trials
Update on HIV lipodystrophy
Kravcik, S
Hiv Clinical Trials, 5(3): 152-167.

Pediatrics
Hyperlactatemia in human immunodeficiency virus-uninfected infants who are exposed to antiretrovirals
Noguera, A; Fortuny, C; Munoz-Almagro, C; Sanchez, E; Vilaseca, MA; Artuch, R; Pou, J; Jimenez, R
Pediatrics, 114(5): E598-E603.
10.1542/peds.2004-0955
CrossRef
Osteoporosis International
Osteoporosis In Turkish HIV/AIDS patients: comparative analysis by dual energy X-ray absorptiometry and digital X-ray radiogrammetry
Ozcakar, L; Guven, G; Unal, S; Akmci, A
Osteoporosis International, 16(): 1363-1367.
10.1007/s00198-005-1847-y
CrossRef
AIDS
Metabolic complications of HIV therapy in children
McComsey, GA; Leonard, E
AIDS, 18(): 1753-1768.

Calcified Tissue International
Analysis of bone mineral content in horizontally HIV-infected children naive to antiretroviral treatment
Mora, S; Zamproni, I; Giacomet, V; Cafarelli, L; Figini, C; Vigano, A
Calcified Tissue International, 76(5): 336-340.
10.1007/s00223-004-0020-5
CrossRef
Jaids-Journal of Acquired Immune Deficiency Syndromes
Management of metabolic complications associated with antiretroviral therapy for HIV-1 infection: Recommendations of an International AIDS Society-USA panel
Schambelan, M; Benson, CA; Carr, A; Currier, JS; Dube, MP; Gerber, JG; Grinspoon, SK; Grunfeld, C; Kotler, DP; Mulligan, K; Powderly, WG; Saag, MS
Jaids-Journal of Acquired Immune Deficiency Syndromes, 31(3): 257-275.

Journal of Infection
Osteopenia in HIV-infected women prior to highly active antiretroviral therapy
Teichmann, J; Stephan, E; Lange, U; Discher, T; Friese, G; Lohmeyer, J; Stracke, H; Bretzel, RG
Journal of Infection, 46(4): 221-227.
10.1053/jinf.2002.1109
CrossRef
AIDS
Frequency, risk factors and features of hyperlactatemia in a large number of patients undergoing antiretroviral therapy
Manfredi, R; Motta, R; Patrono, D; Calza, L; Chiodo, F; Boni, P
AIDS, 17(): 2131-2133.

Journal of Clinical Endocrinology & Metabolism
Effects of growth hormone-releasing hormone on bone turnover in human immunodeficiency virus-infected men with fat accumulation
Koutkia, P; Canavan, B; Breu, J; Grinspoon, S
Journal of Clinical Endocrinology & Metabolism, 90(4): 2154-2160.
10.1210/jc.2004-1466
CrossRef
Journal of Acquired Immune Deficiency Syndromes
Bone mineral density abnormalities in patients with HIV infection
Gold, J; Pocock, N; Li, YM
Journal of Acquired Immune Deficiency Syndromes, 30(1): 131-132.

Quarterly Journal of Nuclear Medicine and Molecular Imaging
Bone mass loss and vitamin D metabolism impairment in HIV patients receiving highly active antiretroviral therapy
Madeddu, G; Spanu, A; Solinas, P; Calia, GM; Lovigu, C; Chessa, F; Mannazzu, M; Falchi, A; Mura, MS; Madeddu, G
Quarterly Journal of Nuclear Medicine and Molecular Imaging, 48(1): 39-48.

Future Virology
Impact of age on markers of HIV-1 disease
Pirrone, V; Libon, DJ; Sell, C; Lerner, CA; Nonnemacher, MR; Wigdahl, B
Future Virology, 8(1): 81-101.
10.2217/FVL.12.127
CrossRef
AIDS
Reduced bone mineral density in HIV-infected patients: prevalence and associated factors
Lawson-Ayayi, S; Mehsen, N; Mercié, P; Morlat, P; Thiébaut, R; Dabis, F; for the Groupe d'Epidémiologie Clinique du SIDA en Aquitaine, ; Cazanave, C; Dupon, M; Lavignolle-Aurillac, V; Barthe, N
AIDS, 22(3): 395-402.
10.1097/QAD.0b013e3282f423dd
PDF (122) | CrossRef
AIDS
Reduced bone density in HIV-infected women
Dolan, SE; Huang, JS; Killilea, KM; Sullivan, MP; Aliabadi, N; Grinspoon, S
AIDS, 18(3): 475-483.

PDF (112)
AIDS
HIV-protease inhibitors impair vitamin D bioactivation to 1,25-dihydroxyvitamin D
Cozzolino, M; Vidal, M; Arcidiacono, MV; Tebas, P; Yarasheski, KE; Dusso, AS
AIDS, 17(4): 513-520.

PDF (123)
AIDS
Greater decrease in bone mineral density with protease inhibitor regimens compared with nonnucleoside reverse transcriptase inhibitor regimens in HIV-1 infected naive patients
Duvivier, C; Kolta, S; Assoumou, L; Ghosn, J; Rozenberg, S; Murphy, RL; Katlama, C; Costagliola, D; the ANRS 121 Hippocampe study group,
AIDS, 23(7): 817-824.
10.1097/QAD.0b013e328328f789
PDF (151) | CrossRef
AIDS
Reversibility of lipoatrophy in HIV-infected patients 2 years after switching from a thymidine analogue to abacavir: the MITOX Extension Study
Martin, A; Smith, DE; Carr, A; Ringland, C; Amin, J; Emery, S; Hoy, J; Workman, C; Doong, N; Freund, J; Cooper, DA; for the Mitochondrial Toxicity (MITOX) Study Group,
AIDS, 18(7): 1029-1036.

PDF (105)
AIDS
Bone dysmetabolism in HIV infection: a melting pot of opinions
Urso, R; Visco-Comandini, U; Antonucci, G
AIDS, 17(9): 1416-1417.

PDF (185)
AIDS
Metabolic bone disease in HIV infection
Borderi, M; Gibellini, D; Vescini, F; De Crignis, E; Cimatti, L; Biagetti, C; Tampellini, L; Re, MC
AIDS, 23(11): 1297-1310.
10.1097/QAD.0b013e32832ce85a
PDF (272) | CrossRef
AIDS
First line zidovudine/lamivudine/lopinavir/ritonavir leads to greater bone loss compared to nevirapine/lopinavir/ritonavir
van Vonderen, MG; Lips, P; van Agtmael, MA; Hassink, EA; Brinkman, K; Geerlings, SE; Sutinen, J; Ristola, M; Danner, SA; Reiss, P
AIDS, 23(11): 1367-1376.
10.1097/QAD.0b013e32832c4947
PDF (212) | CrossRef
AIDS
Continuous antiretroviral therapy decreases bone mineral density
for the INSIGHT SMART Body Composition substudy group, ; Grund, B; Peng, G; Gibert, CL; Hoy, JF; Isaksson, RL; Shlay, JC; Martinez, E; Reiss, P; Visnegarwala, F; Carr, AD
AIDS, 23(12): 1519-1529.
10.1097/QAD.0b013e32832c1792
PDF (234) | CrossRef
Current Opinion in Infectious Diseases
Hyperlactatemia syndromes in people with HIV infection
John, M; Mallal, S
Current Opinion in Infectious Diseases, 15(1): 23-29.

PDF (132)
Current Opinion in Infectious Diseases
HIV and bone mineral density
Mallon, PW
Current Opinion in Infectious Diseases, 23(1): 1-8.
10.1097/QCO.0b013e328334fe9a
PDF (386) | CrossRef
JAIDS Journal of Acquired Immune Deficiency Syndromes
Absence of Sustained Hyperlactatemia in HIV-Infected Patients With Risk Factors for Mitochondrial Toxicity
Basar, M; Kashuba, A; Kondo, P; Martinez, A; Giardini, J; Quinn, J; Littles, M; Wingfield, H; Koletar, SL; Adult AIDS Clinical Trials Group A5129 Team, ; Wohl, DA; Pilcher, CD; Evans, S; Revuelta, M; McComsey, G; Yang, Y; Zackin, R; Alston, B; Welch, S
JAIDS Journal of Acquired Immune Deficiency Syndromes, 35(3): 274-278.

PDF (253)
JAIDS Journal of Acquired Immune Deficiency Syndromes
Alendronate, Vitamin D, and Calcium for the Treatment of Osteopenia/Osteoporosis Associated With HIV Infection
Mondy, K; Powderly, WG; Claxton, SA; Yarasheski, KH; Royal, M; Stoneman, JS; Hoffmann, ME; Tebas, P
JAIDS Journal of Acquired Immune Deficiency Syndromes, 38(4): 426-431.

PDF (121)
JAIDS Journal of Acquired Immune Deficiency Syndromes
Osteonecrosis in Patients Infected With HIV: Clinical Epidemiology and Natural History in a Large Case Series From Spain
Gutiérrez, F; Padilla, S; Masiá, M; Flores, J; Boix, V; Merino, E; Galindo, J; Ortega, E; López-Aldeguer, J; Galera, C; HIV-related Osteonecrosis Study Group,
JAIDS Journal of Acquired Immune Deficiency Syndromes, 42(3): 286-292.
10.1097/01.qai.0000225012.53568.20
PDF (107) | CrossRef
JAIDS Journal of Acquired Immune Deficiency Syndromes
HIV Infection-A Risk Factor for Osteoporosis
Thomas, J; Doherty, SM
JAIDS Journal of Acquired Immune Deficiency Syndromes, 33(3): 281-291.

PDF (8322)
JAIDS Journal of Acquired Immune Deficiency Syndromes
Bone Mass in HIV-Infected Patients: Focus on the Role of Therapy and Sex
Vescini, F; Borderi, M; Buffa, A; Sinicropi, G; Tampellini, L; Chiodo, F; Caudarella, R
JAIDS Journal of Acquired Immune Deficiency Syndromes, 33(3): 405-406.

PDF (2240)
JAIDS Journal of Acquired Immune Deficiency Syndromes
Lack of Recurrence of Hyperlactatemia in HIV-Infected Patients Switched From Stavudine to Abacavir or Zidovudine
Lonergan, JT; McComsey, GA; Fisher, RL; Shalit, P; File, TM; Ward, DJ; Williams, VC; Hessenthaler, SM; Lindsey, L; Hernandez, JE; for the ESS40010 (TARHEEL) Study Team,
JAIDS Journal of Acquired Immune Deficiency Syndromes, 36(4): 935-942.

PDF (176)
JAIDS Journal of Acquired Immune Deficiency Syndromes
Tolerability and Safety of HIV Protease Inhibitors in Adults
Sax, PE; Kumar, P
JAIDS Journal of Acquired Immune Deficiency Syndromes, 37(1): 1111-1124.

PDF (477)
JAIDS Journal of Acquired Immune Deficiency Syndromes
Evolution and Predictors of Change in Total Bone Mineral Density Over Time in HIV-Infected Men and Women in the Nutrition for Healthy Living Study
Jacobson, DL; Spiegelman, D; Knox, TK; Wilson, IB
JAIDS Journal of Acquired Immune Deficiency Syndromes, 49(3): 298-308.
10.1097/QAI.0b013e3181893e8e
PDF (127) | CrossRef
JAIDS Journal of Acquired Immune Deficiency Syndromes
Osteoporosis in HIV-Infected Subjects: A Combined Effect of Highly Active Antiretroviral Therapy and HIV Itself?
Bongiovanni, M; Fausto, A; Cicconi, P; Menicagli, L; Melzi, S; Ligabo, VE; Cornalba, G; Bini, T; Sardanelli, F; Monforte, Ad
JAIDS Journal of Acquired Immune Deficiency Syndromes, 40(4): 503-504.

PDF (139)
Journal of Pediatric Gastroenterology and Nutrition
Predictors of Bone Mineral Density in Human Immunodeficiency Virus-1 Infected Children
Jacobson, DL; Spiegelman, D; Duggan, C; Weinberg, GA; Bechard, L; Furuta, L; Nicchitta, J; Gorbach, SL; Miller, TL
Journal of Pediatric Gastroenterology and Nutrition, 41(3): 339-346.

PDF (94)
The Pediatric Infectious Disease Journal
Metabolic complications of antiretroviral therapy in children
LEONARD, EG; MCCOMSEY, GA
The Pediatric Infectious Disease Journal, 22(1): 77-84.

PDF (284)
The Pediatric Infectious Disease Journal
Hyperlactatemia in human immunodeficiency virus-infected children receiving antiretroviral treatment
JIMÉNEZ, R; NOGUERA, A; FORTUNY, C; SANCHEZ, E; ARTUCH, R; VILASECA, MA; MUÑOZ-ALMAGRO, C; POU, J
The Pediatric Infectious Disease Journal, 22(9): 778-782.

PDF (68)
Journal of Investigative Medicine
Regional Body Fat Distribution in HIV‐Infected Patients with Lipodystrophy
Dinges, WL; Chen, D; Snell, PG; Weatherall, PT; Peterson, DM; Garg, A
Journal of Investigative Medicine, 53(1): 15-25.
10.2310/6650.2005.00001
PDF (1707) | CrossRef
Back to Top | Article Outline
Keywords:

osteoporosis; lactic acidemia; mitochondrial toxicity; antiretroviral therapy

© 2001 Lippincott Williams & Wilkins, Inc.

Login

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.