Osteoporosis and osteopenia are not associated with T-cell activation in older cART-treated HIV-infected patients

Krikke, M., Klomberg, R. C. W., van der Veer, E., Tesselaar, K., Verhaar, H. J. J., Hoepelman, A. I. M. & Arends, J. E., May-2017, In : The Netherlands Journal of Medicine. 75, 4, p. 138-144 7 p.

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  • Osteoporosis and osteopenia are not associated with T-cell activation in older cART-treated HIV-infected patients.

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  • M. Krikke
  • R. C. W. Klomberg
  • E. van der Veer
  • K. Tesselaar
  • H. J. J. Verhaar
  • A. I. M. Hoepelman
  • J. E. Arends

Background: A higher risk of developing osteopenia/ osteoporosis has been seen in HIV-infected patients. We compared HIV-infected patients, all treated with combination antiretroviral therapy (cART), with a low bone mineral density (BMD) (T-score <-I) to those with a normal BMD (T-score > -I), examining the relation with T-cell activation and bone turnover markers (c-terminal telopeptide (CTX) and procollagen type I amino-terminal propeptide (PINP)).

Methods: In this single visit pilot study, bone turnover markers, T-cell activation (CD38 + HLA - DR +) and senescence (CD57+) of T cells were measured in patients who had previously undergone dual energy X-ray absorptiometry scanning.

Results: All study participants (n = I6) were male, on cART, with a median age of 6I years (IQR 56-66). Nine patients had osteopenia/osteoporosis. When comparing the patients with osteopenia/osteoporosis with those with a normal BMD, no differences in activation and senescence were found. A relation was seen between higher bone formation (PINP) and patients who were on cART for longer. The median length of cART use was 5.5 years (IQR 4.5-7.8), with all patients on nucleoside reverse transcriptase inhibitors, 88% on tenofovir, 63% on non-nucleoside reverse transcriptase inhibitors (NNRTIs) and 38% on protease inhibitors. Osteopenia/osteoporosis was seen in 100% of the patients on protease inhibitors versus 30% of those on NNRTIs.

Conclusion: This study did not find an association between activated T cells and BMD, thus did not explain the higher prevalence of osteopenia/osteoporosis in HIV-infected patients. Interestingly, this small pilot showed that cART might influence BMD, with a possible negative effect for protease inhibitors and a possible protective effect for NNRTIs. These results warrant further investigation.

Original languageEnglish
Pages (from-to)138-144
Number of pages7
JournalThe Netherlands Journal of Medicine
Issue number4
Publication statusPublished - May-2017


  • Bone turnover markers, combination antiretroviral therapy, HIV-infection, immune activation, osteoporosis, T-cell activation, BONE-MINERAL DENSITY, ANTIRETROVIRAL THERAPY, PROTEASE INHIBITORS, TURNOVER, DISEASE, PREVALENCE, MARKERS

ID: 47266782