Heel quantitative ultrasound in HIV-infected patients: a cross-sectional study

被引:4
作者
Pinzone, Marilia Rita [1 ]
Castronuovo, Daniela [1 ]
Di Gregorio, Adriana [1 ]
Celesia, Benedetto Maurizio [1 ]
Gussio, Maria [1 ]
Borderi, Marco [2 ]
Maggi, Paolo [3 ]
Santoro, Carmen Rita [3 ]
Madeddu, Giordano [4 ]
Cacopardo, Bruno [1 ]
Nunnari, Giuseppe [1 ]
机构
[1] Univ Catania, ARNAS Garibaldi Hosp, Dept Clin & Expt Med, Div Infect Dis, Via Palermo 636, I-95100 Catania, Italy
[2] Univ Bologna, Infect Dis Unit, Dept Med & Surg Sci, Alma Mater Studiorum, Bologna, Italy
[3] Policlin Univ Bari, Inst Infect Dis, Bari, Italy
[4] Univ Sassari, Infect Dis Unit, Dept Clin & Expt Med, I-07100 Sassari, Italy
关键词
BMD; DXA; Heel; HIV; Osteoporosis; QUS; BONE-MINERAL DENSITY; TENOFOVIR DISOPROXIL FUMARATE; FRACTURE RISK; ANTIRETROVIRAL THERAPY; ABACAVIR-LAMIVUDINE; OSTEOPOROSIS; DISEASE; WOMEN; MANAGEMENT; MEN;
D O I
10.1007/s15010-015-0842-2
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
HIV infection has been associated with increased risk of osteoporosis and fragility fractures. Dual-energy X-ray absorptiometry (DXA) is the reference standard to assess bone mineral density (BMD); however, it is not easily accessible in several settings. Heel Quantitative ultrasound (QUS) is a radiation-free, easy-to-perform technique, which may help reducing the need for DXA. In this cross-sectional study, we used heel QUS (Hologic Sahara(A (R))) to assess bone status in a cohort of HIV-infected patients. A QUS stiffness index (QUI) threshold > 83 was used to identify patients with a low likelihood of osteoporosis. Moreover, we compared QUS results with those of 36 sex- and age-matched HIV-negative controls. 244 HIV-positive patients were enrolled. Median heel QUI value was 83 (73-96) vs. 93 (IQR 84-104) in the control group (p = 0.04). 110 patients (45 %) had a QUI value a parts per thousand currency sign83. Risk factors for low QUI values were age (OR 1.04 per year, 95 % CI 1.01-1.07, p = 0.004), current use of protease inhibitors (OR 1.85, CI 1.03-3.35, p = 0.039), current use of tenofovir (OR 2.28, CI 1.22-4.27, p = 0.009) and the number of risk factors for secondary osteoporosis (OR 1.46, CI 1.09-1.95, p = 0.01). Of note, QUI values were significantly correlated with FRAX score (r = -0.22, p = 0.004). According to EACS guidelines, 45 % of patients had risk factors for osteoporosis which make them eligible for DXA. By using QUS, we may avoid DXA in around half of them. As HIV-positive patients are living longer, the prevalence of osteoporosis is expected to increase over time. Appropriate screening, prevention and treatment are crucial to preserve bone health in this population. The use of screening techniques, such as heel QUS, may help reducing the need for DXA. Further studies are needed to define the diagnostic accuracy of this promising technique in the setting of HIV.
引用
收藏
页码:197 / 203
页数:7
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