Prevalence of reduced bone mineral density in human immunodeficiency virus infected compared to uninfected individuals in Malaysia — ASN Events
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Prevalence of reduced bone mineral density in human immunodeficiency virus infected compared to uninfected individuals in Malaysia (#173)

Pauline Siew Mei Lai 1 , Sheron Sir Loon Goh 1 , Alexander Tong Boon Tan 2 , Sasheela Ponnampalavanar 2 , Reena Rajasuriar 3 4 , Raja Iskandar Shah Raja Azwa 2 , Sharifah Faridah Syed Omar 2 , Helmi Sulaiman 2 , Nor Syuhada Ahmad Bashah 4 , Meng Li Chong 4 , Megan McStea 4 , Shahrul Bahyah Kamaruzzaman 2 , Adeeba Kamarulzaman 2
  1. Primary Care Medicine, University of Malaya, Kuala Lumpur, WILAYAH PERSEKUTUAN, Malaysia
  2. Medicine, University of Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia
  3. Pharmacy, University of Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia
  4. Centre of Excellence for Research in AIDS, University of Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia

The commencement of antiretroviral therapy (ART) in human immunodeficiency virus (HIV)-infected individuals has decreased HIV-related complications and improved survival. However, studies have shown that there is a higher prevalence of reduced bone mineral density (BMD) in HIV-infected individuals despite control of HIV disease with ART treatment. Therefore, our aim was to determine the prevalence of reduced BMD, vitamin D level, the 10-year probability of fracture risk, and its associated risk factors in HIV-infected and HIV-uninfected individuals in Malaysia. HIV-infected individuals aged ≥25 years and virologically suppressed on ART for at least 1 year, were recruited from September 2014-September 2016, at a tertiary hospital in Malaysia. HIV-uninfected individuals were recruited from the community. A total of 684 potential participants were approached; of which 640 participants agreed to participate (response rate=93.6%). Participants were then matched for gender and age, finally giving 206 participants in each group. The median age of participants was 40.0 (IQR:33.0-51.0) years. The majority were male (73.8%) and Chinese (64.1%). A significantly higher number of HIV-infected participants had reduced BMD (osteopenia/osteoporosis) compared to uninfected participants (73.8% versus 57.3%, p<0.001), and osteoporosis (14.1% versus 5.3%, p<0.001). Similarly, vitamin D deficiency (<50nmol/L) was significantly higher in HIV-infected compared to uninfected participants (65.0% versus 30.1%, p<0.001). The 10-year probability of sustaining a hip fracture in HIV-infected individuals (0.4%) was higher than in HIV-uninfected individuals (0.2%, p=0.003). There was no difference in the major osteoporosis fracture risk between the two groups (p=0.066). Lower BMI was the only risk factor significantly associated with reduced BMD. In conclusion, the prevalence of reduced BMD, vitamin D deficiency and the 10-year probability of sustaining a hip fracture was higher in HIV-infected compared to HIV-uninfected individuals. Lower BMD was found to be associated with reduced BMI.