Bone mineral density characteristics and associated factors in HIV-infected/aids patients receiving antiretroviral therapy: a cross-sectional study based on dual-energy X-ray absorptiometry

doi:10.19871/j.cnki.xfcrbzz.2025.06.009

Abstract

Abstract: Objective To evaluate the application value of dual-energy X-ray absorptiometry (DXA) in the quantitative assessment of bone mineral density (BMD) among patients with HIV infection/AIDS receiving antiretroviral therapy (ART), and to identify key factors associated with BMD alterations, so as to provide evidence for optimizing bone health management during ART. Method A total of 185 HIV-infected/AIDS patients admitted to the Department of Infectious Diseases of Chengdu Public Health Clinical Medical Center between January and December 2024 were retrospectively enrolled. Demographic characteristics, body mass index (BMI), and ART regimens were collected. According to the DXA results, patients were categorized into a normal bone mass group and a bone mass abnormality group (including osteopenia and osteoporosis). Clinical characteristics and BMD indices were compared between the two groups. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the discriminatory power of age, sex, and the use of tenofovir disoproxil fumarate (TDF) in predicting bone mass abnormality. Result Among the 185 participants, 119 (64.32%) were male and 66 (35.68%) were female, with a mean age of (59.38±11.92) years. Bone mass abnormality was identified in 137 patients (74.05%). Compared with patients aged ≤50 years, male patients, and those not receiving TDF treatment, patients aged >50 years, female patients, and those receiving TDF treatment all had a significantly higher incidence of abnormal bone mass (all P<0.05). ROC analysis showed that the combined model incorporating female sex, age >50 years, and TDF use achieved an area under the curve (AUC) of 0.781 (95%CI: 0.700-0.862, P<0.001), with a sensitivity of 0.920 and a specificity of 0.521. Conclusion The prevalence of bone mass abnormality is 74.05% among HIV-infected/AIDS patients receiving ART. Female sex, age >50 years, and TDF exposure are associated with an increased risk of bone mass abnormality. A multivariate prediction model combining these three factors improves the diagnostic performance for bone mass abnormality and may support risk stratification and clinical management of bone health in HIV-infected/AIDS patients.

Key words: Dual energy X-ray absorptiometry, Human immunodeficiency virus, Acquired immunodeficiency syndrome, Antiretroviral therapy, Bone density, Tenofovir

CLC Number:

R512.91

Hou Keke, Yang Jia, He Jianglin, Li Tao, Zhang Shuying, Wan Ting, Xiong Lei, Gao Yueqin, Fu Siqi, Zhang Na. Bone mineral density characteristics and associated factors in HIV-infected/aids patients receiving antiretroviral therapy: a cross-sectional study based on dual-energy X-ray absorptiometry[J]. Electronic Journal of Emerging Infectious Diseases, 2025, 10(6): 57-62.

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