Evaluation of Bone Mineral Density in Treatment-naive Patients with Human Immundeficiency Virus Infection

Objective: Human Immundeficiency virus (HIV) infection is a risk factor for low bone mineral density (BMD). International HIV/AIDS guidelines do not recommend BMD screening for every patient. In this study, we aimed to compare the risk factors for the development of osteoporosis/osteopenia between patients with treatment naive HIV infection, to whom routine BMD screening is not recommended and patients with osteoporosis/osteopenia risk factors like men over 50 years of age, postmenopausal women to whom routine BMD screening is recommended. Materials and Methods: A database was created in which the demographic, clinical and laboratory features of patients with HIV infection were recorded in the infectious diseases outpatient clinic between January 2015 and June 2019. A total of 284 HIV-infected patients with dual-energy X-ray absorptiometry (DXA) measurements at admission and before antiretroviral treatment were included in the study. The characteristics of those aged >= 50 years/postmenopausal and <50 years naive HIV-infected patients with osteoporosis/osteopenia were compared. Results: Overall, 131 (46%) of 284 treatment-naive HIV-infected individuals were diagnosed with osteoporosis/osteopenia by DXA. The osteoporosis/osteopenia rate was 42.9% (106/247) and 67% (25/37) in those aged <50 and >= 50 years, respectively (p= 0.007). Osteoporosis was detected in 26 patients and 16 (61.5%) were <50 years. Further, decrease in BMD was most commonly observed in the femoral region among the elderly and in the lumbar and femoral regions among the young individuals (p<0.001). Conclusion: This study reveals a high rate of decrease in BMD among our young patients who were not exposed to antiretroviral therapy. The early detection of the presence of osteoporosis/osteopenia is important to increase the quality of life and to decrease the drug load. Therefore, we recommend performing diagnostic tests at any age in naive patients for low BMD detection and early treatment, regardless of the treatment.