Abstract

Objective: HIV infection may negatively impact bone microarchitecture, leading to reduced bone mineral density (BMD). This study compared the BMD of individuals under the age of 50 living with HIV to that of HIV-negative controls and evaluated the effect of antiretroviral therapy (ART) on BMD.

Methods: In this cross-sectional case-control study conducted at the University of Health Sciences Ümraniye Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, medical records of 72 HIV-positive and 44 HIV-negative individuals aged 18–49 years were retrospectively reviewed between December 2021 and March 2022. Bone mineral density was measured using dual-energy X-ray absorptiometry (DEXA).

Results: The prevalence of low BMD was 16.7% among HIV-positive individuals and 6.8% among HIV-negative controls. Lumbar spine T- and Z-scores were significantly lower in the HIV-positive group (p<0.05). Individuals diagnosed with HIV for more than three years and receiving ART for more than three years had significantly lower femoral neck Z-scores (p<0.05). Smoking and low body mass index were associated with decreased BMD (p<0.05). No significant association was observed between BMD and CD4+ T cell count, viral load, vitamin D, or calcium levels.

Conclusion: Individuals under 50 years of age living with HIV have lower BMD compared to HIV-negative individuals. These findings suggest that HIV infection may contribute to decreased BMD even in younger populations. Dual-energy X-ray absorptiometry screening should be considered in HIV-positive individuals under 50 years of age with additional risk factors for reduced BMD. Larger, multicenter studies are needed to confirm these results.

Keywords: HIV, osteoporosis, bone density